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General NPI Number Information
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NPI Number | 1801846662
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Entity Type | Organization
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Legal Business Name | WHITNEY SLEEP ASSOCIATES LLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 2700 CAMPUS DR SUITE 100
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City | PLYMOUTH
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State | MN
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Zip | 55441-2601
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Country | US
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Telephone | 763-519-0634
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Fax | 763-519-0636
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Provider Business Mailing Address
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Address Line | 2700 CAMPUS DR SUITE 100
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City | PLYMOUTH
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State | MN
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Zip | 55441-2601
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Country | US
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Telephone | 763-519-0634
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Fax | 763-519-0636
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Authorized Official
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Title or Position | PRESIDENT
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Name | COURTNEY WADE WHITNEY
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Credential | DO
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Telephone | 763-519-0634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 39456
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License Number State | MN
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