Whitney Baeza

Individual provider Active NPI Licensed Vocational Nurse · Fort Stewart, GA

NPI 1639542012 · NPPES record last updated Nov 5, 2015

Key facts

NPI
1639542012
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
313970 (TX)
Practice address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone
(915) 540-9548
NPI assigned
Nov 5, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
313970TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 313970 TX Yes

Addresses

Primary practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (915) 540-9548

Other providers in Fort Stewart, GA

All providers in Fort Stewart, GA · Licensed Vocational Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.