Provider Demographics
NPI:1659861078
Name:MARTIGNONI, WHITNEY ALI (BSN, RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:ALI
Last Name:MARTIGNONI
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CALYPSO CT
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3714
Mailing Address - Country:US
Mailing Address - Phone:361-412-7412
Mailing Address - Fax:
Practice Address - Street 1:105 CALYPSO CT
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3714
Practice Address - Country:US
Practice Address - Phone:361-412-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX843930163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant