Provider Demographics
NPI:1093267049
Name:SHIFLETT, WHITNEY (BSN, RN)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:SHIFLETT
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 BUR OAK LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5449
Mailing Address - Country:US
Mailing Address - Phone:719-469-0339
Mailing Address - Fax:
Practice Address - Street 1:2100 N DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-9412
Practice Address - Country:US
Practice Address - Phone:575-769-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1636394163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse