Provider Demographics
NPI:1679356976
Name:WHITAKER, JANAE LEIGH (FNP-C)
Entity Type:Individual
Prefix:
First Name:JANAE
Middle Name:LEIGH
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-4783
Mailing Address - Country:US
Mailing Address - Phone:402-328-7029
Mailing Address - Fax:
Practice Address - Street 1:3910 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4783
Practice Address - Country:US
Practice Address - Phone:402-328-7029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily