Provider Demographics
NPI:1285082396
Name:WHITEHEAD, WILLIAM (RN)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WEST ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2606
Mailing Address - Country:US
Mailing Address - Phone:518-852-3738
Mailing Address - Fax:518-446-8344
Practice Address - Street 1:60 ACADEMY ROAD
Practice Address - Street 2:PARSONS CHILD AND FAMILY CENTER/
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-852-3738
Practice Address - Fax:518-447-8344
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283514-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator