=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447051693
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH ANN WHITTINGTON BSN, RN, CCRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2025
-----------------------------------------------------
Last Update Date | 03/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 4TH ST
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71301-8421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-769-5200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1363 SHIRLEY RD
-----------------------------------------------------
City | BUNKIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71322-1570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-359-5292
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine Registered Nurse
-----------------------------------------------------
License Number | RN128407
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------