Provider Demographics
NPI:1114124203
Name:WHELAN, NANCY C (RN,APN-C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:C
Last Name:WHELAN
Suffix:
Gender:F
Credentials:RN,APN-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1123 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1005
Mailing Address - Country:US
Mailing Address - Phone:908-355-0355
Mailing Address - Fax:
Practice Address - Street 1:200 LYONS AVE
Practice Address - Street 2:BUILDING L-5 PEDIATRIC GASTROENTEROLOGY
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2026
Practice Address - Country:US
Practice Address - Phone:973-926-7280
Practice Address - Fax:973-705-3148
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NO10834400163W00000X
NJ26NN10834400363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse