Provider Demographics
NPI:1265466239
Name:WHITNEY, CHRISTINA M (CNS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05841-NS364SN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeuroscience
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000224409OtherUNISON
OH2510661Medicaid
OH364129OtherWELLCARE MEDICAID
OH000000510699OtherANTHEM
OH751027OtherBUCKEYE MEDICAID
OH7307649OtherAETNA
MI1265466239OtherMICHIGAN MEDICAID
OHWHNS01893Medicare PIN
OH000000510699OtherANTHEM
MI1265466239OtherMICHIGAN MEDICAID