Provider Demographics
NPI:1871914135
Name:WHALEY, NISHA
Entity type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:WHALEY
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 1:320 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-4832
Mailing Address - Country:US
Mailing Address - Phone:620-504-6313
Mailing Address - Fax:620-504-6315
Practice Address - Street 1:320 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-4832
Practice Address - Country:US
Practice Address - Phone:620-504-6313
Practice Address - Fax:620-504-6315
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1551237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist