Provider Demographics
NPI:1992913123
Name:WHITENER, CATHERINE LYNN
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:LYNN
Last Name:WHITENER
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 1:2328 N NOLAN DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167-8894
Mailing Address - Country:US
Mailing Address - Phone:812-883-2878
Mailing Address - Fax:
Practice Address - Street 1:2328 N NOLAN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-8894
Practice Address - Country:US
Practice Address - Phone:812-883-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN8904-31-6002343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)