Individual
JERI WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
803 GRANT AVE, LAKE KATRINE, NY 12449-5352
(845) 331-5064
Mailing address
803 GRANT AVE, LAKE KATRINE, NY 12449-5352
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
632977-1
NY
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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