Provider Demographics
NPI:1437308103
Name:WHITLEDGE, LISBETH EMGE (RN)
Entity Type:Individual
Prefix:
First Name:LISBETH
Middle Name:EMGE
Last Name:WHITLEDGE
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 1:2800 KISSEL RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47720-7150
Mailing Address - Country:US
Mailing Address - Phone:812-480-4301
Mailing Address - Fax:812-963-1191
Practice Address - Street 1:2800 KISSEL RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47720-7150
Practice Address - Country:US
Practice Address - Phone:812-480-4301
Practice Address - Fax:812-963-1191
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28071790A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse