Provider Demographics
NPI:1275393159
Name:WHITTINGTON, C KENYATTA
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:KENYATTA
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7461 CROWNER DR
Mailing Address - Street 2:A 0081
Mailing Address - City:DIMONDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48821-5003
Mailing Address - Country:US
Mailing Address - Phone:954-473-6600
Mailing Address - Fax:
Practice Address - Street 1:7461 CROWNER DR
Practice Address - Street 2:A 0081
Practice Address - City:DIMONDALE
Practice Address - State:MI
Practice Address - Zip Code:48821-5003
Practice Address - Country:US
Practice Address - Phone:954-473-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program