Provider Demographics
NPI:1841098423
Name:MCWHORTER, IVALYN
Entity type:Individual
Prefix:
First Name:IVALYN
Middle Name:
Last Name:MCWHORTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 ROYCE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5924
Mailing Address - Country:US
Mailing Address - Phone:347-262-3865
Mailing Address - Fax:
Practice Address - Street 1:1466 ROYCE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5924
Practice Address - Country:US
Practice Address - Phone:347-262-3865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58924-01163WH0200X
NY582492-01163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health