Provider Demographics
NPI:1336304500
Name:WHITING, EMILY TERESA (RN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:TERESA
Last Name:WHITING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 TOMLINSON RD
Mailing Address - Street 2:
Mailing Address - City:HOMERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31634-7121
Mailing Address - Country:US
Mailing Address - Phone:315-529-6533
Mailing Address - Fax:
Practice Address - Street 1:1058 TOMLINSON RD
Practice Address - Street 2:
Practice Address - City:HOMERVILLE
Practice Address - State:GA
Practice Address - Zip Code:31634-7121
Practice Address - Country:US
Practice Address - Phone:315-529-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN087196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse