Provider Demographics
NPI:1164713434
Name:WHITLEY, CINDY TAYLOR (CPHT)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:TAYLOR
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4761 WARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4359
Mailing Address - Country:US
Mailing Address - Phone:252-399-2109
Mailing Address - Fax:252-399-2136
Practice Address - Street 1:4761 WARD BLVD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4359
Practice Address - Country:US
Practice Address - Phone:252-399-2109
Practice Address - Fax:252-399-2136
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00448183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician