Provider Demographics
NPI:1457156135
Name:WHITTINGTON, MYRETTA (LPN)
Entity type:Individual
Prefix:MRS
First Name:MYRETTA
Middle Name:
Last Name:WHITTINGTON
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:WILBER
Mailing Address - State:NE
Mailing Address - Zip Code:68465-4000
Mailing Address - Country:US
Mailing Address - Phone:402-821-2266
Mailing Address - Fax:
Practice Address - Street 1:900 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WILBER
Practice Address - State:NE
Practice Address - Zip Code:68465-4000
Practice Address - Country:US
Practice Address - Phone:402-821-2266
Practice Address - Fax:402-821-3013
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20809164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse