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NPI Code Detail

MEDICARE: MS. CONNIE R WHITENER BSN

MEDICARE: MS. CONNIE R WHITENER BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN60098710WA
2163WC0400XCase Management Registered NurseRN156695AZ
3163WP2201XAmbulatory Care Registered NurseRN156695AZ

General Provider Information

NPI Number : 1982970588
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CONNIE R WHITENER BSN
Provider Business Mailing Address
First Line : 12033 AGENCY ROAD
Second Line :
City : PARKER
State : AZ
Zip : 85344
Country : US
Telephone Number : 928-669-2137
Fax Number : 928-663-3131
Provider Business Practice Location Address
First Line : 12033 AGENCY RD
Second Line :
City : PARKER
State : AZ
Zip : 85344-7718
Country : US
Telephone Number : 928-669-2137
Fax Number : 928-669-3131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2012
Last Update Date : 03/28/2012

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