Provider Demographics
NPI:1578448502
Name:WHITAKER, SARAH MICHSHELL
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHSHELL
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NASH ST W
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4012
Mailing Address - Country:US
Mailing Address - Phone:252-452-1276
Mailing Address - Fax:
Practice Address - Street 1:121 NASH ST W
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4012
Practice Address - Country:US
Practice Address - Phone:252-452-1276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No372600000XNursing Service Related ProvidersAdult Companion
No251J00000XAgenciesNursing Care
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNP6972OtherNURSING POOL LICENSE