Individual
STEPHANIE C WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
705 RILEY HOSPITAL DR, ROOM 2001, INDIANAPOLIS, IN 46202-5109
(317) 944-9981
(317) 944-0282
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
71002852
IN
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
71002852A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000599654
ANTHEM
IN
01
—
P00926488
RAILROAD MEDICARE
IN
Enumeration date
01/15/2009
Last updated
12/15/2020
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