Provider Demographics
NPI:1588921373
Name:CERNIK, WHITNEY KAY
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:KAY
Last Name:CERNIK
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 1:17810 W CENTER RD
Mailing Address - Street 2:T-1777
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17810 W CENTER RD
Practice Address - Street 2:T-1777
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2308
Practice Address - Country:US
Practice Address - Phone:402-697-4876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist