Provider Demographics
NPI:1306525928
Name:WHYTE, WHITNEY (LPN)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:WHYTE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13525 BARTRAM PARK BLVD UNIT 1331
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5267
Mailing Address - Country:US
Mailing Address - Phone:904-553-4862
Mailing Address - Fax:
Practice Address - Street 1:13525 BARTRAM PARK BLVD UNIT 1331
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5267
Practice Address - Country:US
Practice Address - Phone:904-553-4862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 251E00000X, 253Z00000X
FLPN5227127164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care