Healthcare Provider Details

I. General information

NPI: 1275867038
Provider Name (Legal Business Name): COURTNEY ANNE DIPAOLO WHELAN GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 EDGERTON DR
NORTH FALMOUTH MA
02556-2821
US

IV. Provider business mailing address

297 NORTH ST STE 221
HYANNIS MA
02601-5133
US

V. Phone/Fax

Practice location:
  • Phone: 508-778-4777
  • Fax:
Mailing address:
  • Phone: 508-862-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN274821
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN274821
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: