Provider Demographics
NPI:1073025706
Name:WHITENER, CINDY R
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:R
Last Name:WHITENER
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:CINDY
Other - Middle Name:R
Other - Last Name:STARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3543 SKY HAWK DR
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62221-4465
Mailing Address - Country:US
Mailing Address - Phone:618-767-1428
Mailing Address - Fax:
Practice Address - Street 1:3543 SKY HAWK DR
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62221-4465
Practice Address - Country:US
Practice Address - Phone:618-767-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide