Provider Demographics
NPI:1013464734
Name:BREEN, WHITNEY
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:
Last Name:BREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:HENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7501 MISSION RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4216
Mailing Address - Country:US
Mailing Address - Phone:913-632-9880
Mailing Address - Fax:913-632-9889
Practice Address - Street 1:7501 MISSION RD STE 103
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4216
Practice Address - Country:US
Practice Address - Phone:913-632-9880
Practice Address - Fax:913-632-9889
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5377947363LF0000X
OH395809163W00000X
NE79618163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily