Provider Demographics
NPI:1134538341
Name:MIRVIS, WHITNEY FIELDS (RN, MSN,CNM, IBCIC)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:FIELDS
Last Name:MIRVIS
Suffix:
Gender:F
Credentials:RN, MSN,CNM, IBCIC
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:LENGER
Other - Last Name:MIRVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, MSN,CNM, IBCLC
Mailing Address - Street 1:3535 OLENTANGY RIVER RD
Mailing Address - Street 2:WOMEN'S CENTER
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3908
Mailing Address - Country:US
Mailing Address - Phone:614-566-5094
Mailing Address - Fax:614-566-1869
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:1ST FLOOR YELLOW
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-5094
Practice Address - Fax:614-566-5094
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 142265163WL0100X
OHCOA 17730-NP363LW0102X
OHCOA 17732-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health