Provider Demographics
NPI:1710292214
Name:WHITLOW, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:WHITLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MUNRO AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-5000
Practice Address - Country:US
Practice Address - Phone:609-898-6368
Practice Address - Fax:609-898-6962
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10694600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse