Provider Demographics
NPI:1326515404
Name:WHITMAN, ELAINE (RPH)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 GOVETT CRESCENT CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4822
Mailing Address - Country:US
Mailing Address - Phone:702-418-4339
Mailing Address - Fax:
Practice Address - Street 1:4411 E BONANZA RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-3385
Practice Address - Country:US
Practice Address - Phone:702-452-5652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist