Basic Information
| Provider Information | |||||||||
| NPI: | 1184931636 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHIPPLE | ||||||||
| FirstName: | BAMBI | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 E VINE ST | ||||||||
| Address2: | |||||||||
| City: | EDISON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433209604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402626986 | ||||||||
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| Practice Location | |||||||||
| Address1: | 245 NEAL AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT GILEAD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433389372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199466734 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2010 | ||||||||
| LastUpdateDate: | 04/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | PN111900 | OH | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.