Provider Demographics
NPI:1760573158
Name:WHITESEL, FRANKIE LANE (PMHCNS,BC)
Entity type:Individual
Prefix:
First Name:FRANKIE
Middle Name:LANE
Last Name:WHITESEL
Suffix:
Gender:F
Credentials:PMHCNS,BC
Other - Prefix:
Other - First Name:FRANKIE
Other - Middle Name:LANE
Other - Last Name:WHITESEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHCNS,BC
Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-2388
Mailing Address - Fax:317-988-3278
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-2388
Practice Address - Fax:317-988-3278
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28077612A163W00000X
IN70000186A364S00000X, 364SP0809X, 364SP0811X, 364SP0812X, 364SP0813X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SP0811XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Chronically Ill
No364SP0812XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Community
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Geropsychiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100270530AMedicaid
IN100270530AMedicaid