Provider Demographics
NPI: | 1821655283 |
---|---|
Name: | WHITFILED, JESSICA L |
Entity Type: | Individual |
Prefix: | |
First Name: | JESSICA |
Middle Name: | L |
Last Name: | WHITFILED |
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: | 594 HOLLIS ST |
Mailing Address - Street 2: | |
Mailing Address - City: | FRAMINGHAM |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01702-8626 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 857-200-8233 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 594 HOLLIS ST |
Practice Address - Street 2: | |
Practice Address - City: | FRAMINGHAM |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01702-8626 |
Practice Address - Country: | US |
Practice Address - Phone: | 857-200-8233 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2019-05-21 |
Last Update Date: | 2019-06-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | 246Y00000X, 246YC3301X, 246YR1600X, 390200000X, 246YC3302X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 246YC3302X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | Coding Specialist, Physician Office Based |
No | 246Y00000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | |
No | 246YC3301X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | Coding Specialist, Hospital Based |
No | 246YR1600X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | Registered Record Administrator |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | S51136652 | Other | DRIVERS LICENSES |