Provider Demographics
NPI:1396077392
Name:WHITEHEAD-ARTEMUS, RACHEL (LPN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WHITEHEAD-ARTEMUS
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 1:3 MANTEO ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-3013
Mailing Address - Country:US
Mailing Address - Phone:757-327-9144
Mailing Address - Fax:
Practice Address - Street 1:3 MANTEO ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-3013
Practice Address - Country:US
Practice Address - Phone:757-327-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002078686164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse