Provider Demographics
NPI:1467889402
Name:BRANSHAW, WHITNEY (LPN)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:BRANSHAW
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 1:5700 LAKE OTIS PKWY
Mailing Address - Street 2:#77
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1702
Mailing Address - Country:US
Mailing Address - Phone:651-600-4249
Mailing Address - Fax:
Practice Address - Street 1:5700 LAKE OTIS PKWY
Practice Address - Street 2:#77
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1702
Practice Address - Country:US
Practice Address - Phone:651-600-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6838164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse