Provider Demographics
NPI:1427706811
Name:MAYFIELD, WHITNEY R
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:R
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 LAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2964
Mailing Address - Country:US
Mailing Address - Phone:269-548-5257
Mailing Address - Fax:
Practice Address - Street 1:525 LAY BLVD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2964
Practice Address - Country:US
Practice Address - Phone:269-548-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health