Provider Demographics
NPI:1982603064
Name:RINTELMAN, WHITNEY L (PA-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:L
Last Name:RINTELMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:L
Other - Last Name:BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:160 PARKER LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3789
Mailing Address - Country:US
Mailing Address - Phone:570-772-5310
Mailing Address - Fax:
Practice Address - Street 1:60 EXCHANGE ST STE B7
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-7646
Practice Address - Country:US
Practice Address - Phone:912-756-2273
Practice Address - Fax:912-756-3773
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051088363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
50097365OtherCBC
P00919318OtherRAILRAOD MEDICARE
P00919318OtherRAILRAOD MEDICARE