Provider Demographics
NPI:1215210430
Name:WHITCROFT, RICHARD PHILLIP II (RN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PHILLIP
Last Name:WHITCROFT
Suffix:II
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 NEELY ST
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1638
Mailing Address - Country:US
Mailing Address - Phone:724-224-4695
Mailing Address - Fax:
Practice Address - Street 1:5320 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232
Practice Address - Country:US
Practice Address - Phone:412-855-3123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN 311621L163W00000X
SCRN 88214R163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse