Provider Demographics
NPI:1558792846
Name:RAFFAELI, WHITNEY NICHOLE (RN)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:NICHOLE
Last Name:RAFFAELI
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 1:6915 S TIMBER RIDGE LN
Mailing Address - Street 2:APT 3312
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-1384
Mailing Address - Country:US
Mailing Address - Phone:651-434-3988
Mailing Address - Fax:
Practice Address - Street 1:6915 S TIMBER RIDGE LN
Practice Address - Street 2:APT 3312
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-1384
Practice Address - Country:US
Practice Address - Phone:651-434-3988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI198014-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse