Provider Demographics
NPI:1841744778
Name:WHITLOCK, ADAM (RN)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:WHITLOCK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TURTLE DOVE DR
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-9205
Mailing Address - Country:US
Mailing Address - Phone:302-229-7700
Mailing Address - Fax:
Practice Address - Street 1:22 TURTLE DOVE DR
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-9205
Practice Address - Country:US
Practice Address - Phone:302-229-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0038507163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency