Provider Demographics
NPI:1891508404
Name:WHITELEY, COREY
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:WHITELEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 BLADENSBURG RD NE
Mailing Address - Street 2:501
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2241
Mailing Address - Country:US
Mailing Address - Phone:202-867-1334
Mailing Address - Fax:
Practice Address - Street 1:3005 BLADENSBURG RD NE APT 501
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2241
Practice Address - Country:US
Practice Address - Phone:202-867-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health