Provider Demographics
NPI:1407688807
Name:WHITNEY, JOSEPHINE (RD)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 TRINITY HILLS DR APT 8105
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4788
Mailing Address - Country:US
Mailing Address - Phone:512-550-9518
Mailing Address - Fax:
Practice Address - Street 1:1000 GATTIS SCHOOL RD STE 150B
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2566
Practice Address - Country:US
Practice Address - Phone:512-609-0651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88379133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered