Provider Demographics
NPI:1225493232
Name:MOORE-WHITNEY, CAROL (RN, IBCLC, BSN, MST)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MOORE-WHITNEY
Suffix:
Gender:F
Credentials:RN, IBCLC, BSN, MST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 HOSPITAL DR
Mailing Address - Street 2:NVRH,
Mailing Address - City:ST. JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819
Mailing Address - Country:US
Mailing Address - Phone:802-748-7333
Mailing Address - Fax:
Practice Address - Street 1:1315 HOSPITAL DR
Practice Address - Street 2:NORTHEASTERN VERMONT REGIONAL HOSPITAL
Practice Address - City:ST. JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-9962
Practice Address - Country:US
Practice Address - Phone:802-748-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT10725740163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant