Provider Demographics
NPI:1790338390
Name:WHALEY, DESTINY (LPN)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:
Last Name:WHALEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DESTINY
Other - Middle Name:
Other - Last Name:ARTHURS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6300 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3154
Practice Address - Country:US
Practice Address - Phone:937-275-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH169384164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse