Provider Demographics
NPI:1427161900
Name:WHITTEN, LEAH M (RN)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:M
Last Name:WHITTEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BECKETT ST
Mailing Address - Street 2:APT 2
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4477
Mailing Address - Country:US
Mailing Address - Phone:207-771-3533
Mailing Address - Fax:
Practice Address - Street 1:1 VA CENTER
Practice Address - Street 2:TOGUS VA MEDICAL CENTER
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME040095163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health