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General NPI Number Information
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NPI Number | 1235074618
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Entity Type | Organization
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Legal Business Name | WHIGHAM LEGACY TRUST
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/25/2026
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Provider Practice Location Address
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Address Line | 213 DOVER RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2506
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Country | US
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Telephone | 757-403-1383
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 415
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City | ROCKY MOUNT
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State | NC
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Zip | 27802-0415
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Country | US
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Telephone | 757-403-1383
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTOPHER WHIGHAM SR.
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Credential | MHT
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Telephone | 757-403-1383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0812X
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Taxonomy Name | Community Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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