Charlissa Whitted, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

20120941 Issued in LA

Practice address

2110 Oak Park Blvd
Lake Charles, LA 70601-7864

Phone

(337) 263-3792

NPI assigned

Jan 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Charlissa Boyd Former name

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1982294807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7494 COLUMBIA DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706050286",
            "telephone_number": "337-794-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017864",
            "telephone_number": "337-263-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTED",
        "first_name": "CHARLISSA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "20120941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLISSA",
            "last_name": "BOYD",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melanie Bousegard White, FNP
• Rachel White
• Sarah Schultz White, BCBA
• Jared R Whitehead, A.P.R.N.
• Jerry L Whiteman, PHD.
• Alexandra Widcamp - Feagin, DPT
• Regan Z Wild
• Errol P. Wilder, M.D.
• Bruce Wiley, M.D.
• Brittany Wilkins

• Licensed Practical Nurse in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Licensed Practical Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.