Provider Demographics
NPI:1699857334
Name:WHITBECK, NORA JOHANNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:JOHANNA
Last Name:WHITBECK
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 1:500 W OLD LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-4608
Mailing Address - Country:US
Mailing Address - Phone:928-537-6259
Mailing Address - Fax:928-537-6214
Practice Address - Street 1:500 W OLD LINDEN RD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-4608
Practice Address - Country:US
Practice Address - Phone:928-537-6259
Practice Address - Fax:928-537-6214
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN045757163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool