Provider Demographics
NPI:1851097737
Name:WHITFIELD, RENITA (RN)
Entity type:Individual
Prefix:
First Name:RENITA
Middle Name:
Last Name:WHITFIELD
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 1:3100 CASHWELL DR UNIT 11096
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-2048
Mailing Address - Country:US
Mailing Address - Phone:919-330-3548
Mailing Address - Fax:
Practice Address - Street 1:135 W WALNUT ST UNIT D
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3650
Practice Address - Country:US
Practice Address - Phone:252-221-9159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8964732163WM0705X, 163WH0200X, 163WI0500X, 163WW0000X, 163W00000X
NCHC7334163WH0200X, 163WI0500X, 163WM0705X, 372500000X, 163WC1500X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No372500000XNursing Service Related ProvidersChore Provider
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC7334OtherNON-CERTIFIED HOME CARE SERVICE