Provider Demographics
NPI:1881428589
Name:THOMPSON, WHITNEY DANIELLE
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:DANIELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:WHITNEY
Other - Middle Name:DANIELLE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20409 WALNUT GROVE LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3352
Mailing Address - Country:US
Mailing Address - Phone:813-904-6825
Mailing Address - Fax:
Practice Address - Street 1:20409 WALNUT GROVE LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3352
Practice Address - Country:US
Practice Address - Phone:813-904-6825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLT512884895470343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)