Provider Demographics
NPI:1205144680
Name:WHALEN, LAUREEN ELIZABETH (RN)
Entity type:Individual
Prefix:MRS
First Name:LAUREEN
Middle Name:ELIZABETH
Last Name:WHALEN
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 1:20 NANCY RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3735
Mailing Address - Country:US
Mailing Address - Phone:845-623-2857
Mailing Address - Fax:
Practice Address - Street 1:20 NANCY RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3735
Practice Address - Country:US
Practice Address - Phone:845-623-2857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353454-1163W00000X
NJ26NR06664500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse