Provider Demographics
NPI:1679044507
Name:CARTER-WHITSETT, LILLIAN MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:MARIE
Last Name:CARTER-WHITSETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LILLIAN
Other - Middle Name:MARIE
Other - Last Name:CARTER-WHITSETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:22097 PIPER AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-2412
Mailing Address - Country:US
Mailing Address - Phone:313-854-6079
Mailing Address - Fax:
Practice Address - Street 1:22097 PIPER AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2412
Practice Address - Country:US
Practice Address - Phone:313-854-6079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704419305163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI611755491Medicaid