Provider Demographics
NPI: | 1205855269 |
---|---|
Name: | WHYTE, DONNA M (FNP-C) |
Entity Type: | Individual |
Prefix: | |
First Name: | DONNA |
Middle Name: | M |
Last Name: | WHYTE |
Suffix: | |
Gender: | F |
Credentials: | FNP-C |
Other - Prefix: | |
Other - First Name: | DONNA |
Other - Middle Name: | M |
Other - Last Name: | WHYTE-ENGLISH |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | FNP-C |
Mailing Address - Street 1: | 103 MYRON ST |
Mailing Address - Street 2: | SUITE A |
Mailing Address - City: | WEST SPRINGFIELD |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01089-1598 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 413-592-1980 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 103 MYRON ST |
Practice Address - Street 2: | SUITE A |
Practice Address - City: | WEST SPRINGFIELD |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01089-1598 |
Practice Address - Country: | US |
Practice Address - Phone: | 413-592-1980 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-19 |
Last Update Date: | 2015-11-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | F337251 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | P00192055 | Other | RAIL ROAD MEDICARE |
MA | NP3001 | Medicare ID - Type Unspecified | |
MA | P22357 | Medicare UPIN | |
MA | UX3964 | Medicare PIN |