Provider Demographics
NPI:1609367861
Name:WHITNEY, MARIA D (RN)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:D
Last Name:WHITNEY
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 1:5408 1ST AVENUE DR NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2608
Mailing Address - Country:US
Mailing Address - Phone:315-278-7474
Mailing Address - Fax:
Practice Address - Street 1:5408 1ST AVENUE DR NW
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2608
Practice Address - Country:US
Practice Address - Phone:315-278-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY426366-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse