Basic Information
| Provider Information | |||||||||
| NPI: | 1699200600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHITEHOUSE | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | TIU | ||||||||
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| Mailing Information | |||||||||
| Address1: | N2198 UNC HOSPITALS | ||||||||
| Address2: | CB #7010 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199665136 | ||||||||
| FaxNumber: | 9849744873 | ||||||||
| Practice Location | |||||||||
| Address1: | N2198 UNC HOSPITALS | ||||||||
| Address2: | CB #7010 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199665136 | ||||||||
| FaxNumber: | 9849744873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2017 | ||||||||
| LastUpdateDate: | 04/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 227445 | NC | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.