Laconna Marye Whittaker, LPN
Licensed Practical Nurse in Brentwood, TN. Individual provider (NPI-1).
NPI number1427368570
StatusActive
Last updated in NPPESOct 7, 2010
Details
- NPI
- 1427368570
- Entity type
- Individual (NPI-1)
- Name
- Laconna Marye Whittaker
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 7, 2010
- Last updated
- Oct 7, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | LPN0000052463 | TN | Yes |
Practice location
750 Old Hickory Blvd Bldg 1Suite 190
Brentwood, TN 37027-4528
Phone 615-661-7594
Mailing address
432 Carl Miller DrAntioch, TN 37013-4408
Phone 615-750-3880
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