Healthcare Provider Details

I. General information

NPI: 1598926719
Provider Name (Legal Business Name): ANALEI MARIE WHITLOCK CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PRINCE WILLIAM RD
DELPHI IN
46923-1758
US

IV. Provider business mailing address

901 PRINCE WILLIAM RD
DELPHI IN
46923-1758
US

V. Phone/Fax

Practice location:
  • Phone: 765-564-3016
  • Fax:
Mailing address:
  • Phone: 765-564-3016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71002693A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71002693A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: