Provider Demographics
NPI:1356318745
Name:NOWAK, WHITNEY B (NP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:B
Last Name:NOWAK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-693-2100
Mailing Address - Fax:603-777-1895
Practice Address - Street 1:212 CALEF HWY
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2322
Practice Address - Country:US
Practice Address - Phone:603-693-2100
Practice Address - Fax:603-777-1895
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH039024-23363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076244Medicaid
P22191Medicare UPIN
NHNP2993Medicare ID - Type Unspecified