Healthcare Provider Details

I. General information

NPI: 1356911614
Provider Name (Legal Business Name): MARY WHITMAN FEW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N PATTERSON AVE UNIT 525
WINSTON SALEM NC
27101-4285
US

IV. Provider business mailing address

530 N PATTERSON AVE UNIT 525
WINSTON SALEM NC
27101-4285
US

V. Phone/Fax

Practice location:
  • Phone: 919-536-8706
  • Fax:
Mailing address:
  • Phone: 919-536-8706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number133599
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number245881
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: