Provider Demographics
NPI:1851097737
Name:WHITFIELD, RENITA (RN)
Entity Type:Individual
Prefix:
First Name:RENITA
Middle Name:
Last Name:WHITFIELD
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 1:3100 CASHWELL DR UNIT 11096
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-2048
Mailing Address - Country:US
Mailing Address - Phone:919-330-3548
Mailing Address - Fax:
Practice Address - Street 1:139 W WALNUT ST UNIT D
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3650
Practice Address - Country:US
Practice Address - Phone:919-330-3548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC7334372600000X, 374U00000X, 376J00000X, 376K00000X, 163WW0000X, 163WH0200X, 163WI0500X, 163WM0705X, 372500000X, 163WC1500X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No372500000XNursing Service Related ProvidersChore Provider
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC7334OtherNON-CERTIFIED HOME CARE SERVICE