Provider Demographics
NPI:1740066232
Name:WHITNEY, AMANDA LEE (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:WHITNEY
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 1:6300 W 13TH AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-2284
Mailing Address - Country:US
Mailing Address - Phone:197-880-7862
Mailing Address - Fax:
Practice Address - Street 1:6300 W 13TH AVE APT 302
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-2284
Practice Address - Country:US
Practice Address - Phone:197-880-7862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1675002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse