Provider Demographics
NPI:1629605407
Name:TODD, WHITNEY NICOLE LORENE (CRNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:NICOLE LORENE
Last Name:TODD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2665 COUNTY HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-5052
Mailing Address - Country:US
Mailing Address - Phone:205-269-5832
Mailing Address - Fax:
Practice Address - Street 1:171 CARRAWAY DR
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5067
Practice Address - Country:US
Practice Address - Phone:205-487-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-173714363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse