Provider Demographics
NPI:1154885648
Name:WHIPPLE, DANITA LEE ANN
Entity type:Individual
Prefix:
First Name:DANITA
Middle Name:LEE ANN
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10132 W 161ST ST S
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-6373
Mailing Address - Country:US
Mailing Address - Phone:325-370-7127
Mailing Address - Fax:
Practice Address - Street 1:10132 W 161ST ST S
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-6373
Practice Address - Country:US
Practice Address - Phone:325-370-7127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator