Nicole K Whiting

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

SE-203972 Issued in ID

Practice address

1065 E Winding Creek Dr Ste 250
Eagle, ID 83616-7246

Phone

(208) 805-2324

NPI assigned

Sep 3, 2024

Last updated

Sep 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1174358956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 SCHULTZ RD",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838438120",
            "telephone_number": "208-310-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 E WINDING CREEK DR STE 250",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167246",
            "telephone_number": "208-805-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "NICOLE",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "PSB94028303",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ID",
            "license": "SE-203972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Johnson Wesolowski, P.T.
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• Amy Whelan, PHD
• Shannon White
• Leah Duncan Whiteman, M.S. SLP-CCC
• Whole Hearted Counseling LLC
• Anthony Arthur Wilburn, LMT
• Wendi Wilch, LCPC
• Joshua Wilding, CADC
• Katie Elizabeth Williams, S.L.P

• Student in an Organized Health Care Education/Training Program in Eagle, ID
• Providers in Eagle, ID by specialty
• Student in an Organized Health Care Education/Training Program in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.