Individual
MRS. NICOLLETTE RENEE WHITFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNA
Contact information
Practice address
320 WHITTINGTON PKWY, SUITE 301, LOUISVILLE, KY 40222-4928
(502) 625-5584
(502) 426-2264
Mailing address
320 WHITTINGTON PKWY, SUITE 301, LOUISVILLE, KY 40222-4928
(502) 625-5584
(502) 426-2264
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1136048
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3008087
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201186460
—
IN
05
—
7100259690
—
KY
01
—
K098318
MEDICARE
KY
Enumeration date
05/20/2013
Last updated
06/11/2019
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