Provider Demographics
NPI:1750055844
Name:WHITTON, CHARMAINE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:CHARMAINE
Middle Name:
Last Name:WHITTON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:CHARMAINE
Other - Middle Name:
Other - Last Name:WHITTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4783
Mailing Address - Country:US
Mailing Address - Phone:718-866-6152
Mailing Address - Fax:
Practice Address - Street 1:38 E 31ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4783
Practice Address - Country:US
Practice Address - Phone:718-866-6152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104006479363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health