Provider Demographics
NPI:1215167853
Name:WHITNEY SLEEP ASSOCIATES LLC
Entity type:Organization
Organization Name:WHITNEY SLEEP ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:763-519-0634
Mailing Address - Street 1:2700 CAMPUS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2601
Mailing Address - Country:US
Mailing Address - Phone:763-422-6734
Mailing Address - Fax:
Practice Address - Street 1:2412 E 117TH ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4898
Practice Address - Country:US
Practice Address - Phone:952-891-1713
Practice Address - Fax:952-891-4625
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITNEY SLEEP ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-16
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic