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General NPI Number Information
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NPI Number | 1265011878
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Entity Type | Individual
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Provider Name | JESSICA JOY WHITTINGTON APRN
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Gender | Female
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60611-2991
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Country | US
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Telephone | 312-227-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 4624 71ST AVE N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-4422
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Country | US
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Telephone | 727-366-9115
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209.023101
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License Number State | IL
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