Provider Demographics
NPI:1760719512
Name:WHITAKER, FUNMILAYO JENNIFER (RN)
Entity Type:Individual
Prefix:
First Name:FUNMILAYO
Middle Name:JENNIFER
Last Name:WHITAKER
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 1:833 HILLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8510
Mailing Address - Country:US
Mailing Address - Phone:484-645-0831
Mailing Address - Fax:215-757-2506
Practice Address - Street 1:833 HILLBROOK LN
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8510
Practice Address - Country:US
Practice Address - Phone:484-645-0831
Practice Address - Fax:215-757-2506
Is Sole Proprietor?:No
Enumeration Date:2009-11-14
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN601756163W00000X
PASP016195363LF0000X
NJ26NJ00646400363LF0000X
NJ26NR14649300163W00000X
GARN215138163W00000X
NY696315163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse