Provider Demographics
NPI:1396389987
Name:WHITMAN, WENDY MARGARET (LPN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MARGARET
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 EAST LABARGE STREET
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839
Mailing Address - Country:US
Mailing Address - Phone:518-681-4201
Mailing Address - Fax:518-746-9033
Practice Address - Street 1:80 EAST LABARGE STREET
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839
Practice Address - Country:US
Practice Address - Phone:518-681-4201
Practice Address - Fax:518-746-9033
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222102-1164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse