Provider Demographics
NPI:1467753459
Name:WHITWORTH, JANET C (RN, FNP-BC, DNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:C
Last Name:WHITWORTH
Suffix:
Gender:F
Credentials:RN, FNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JAMES R THOMPSON BLVD
Mailing Address - Street 2:BLDG D 2015
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62201-1129
Mailing Address - Country:US
Mailing Address - Phone:618-482-6959
Mailing Address - Fax:618-482-8311
Practice Address - Street 1:601 JAMES R THOMPSON BLVD
Practice Address - Street 2:BLDG D 2015
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62201-1129
Practice Address - Country:US
Practice Address - Phone:618-482-6959
Practice Address - Fax:618-482-8311
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily