Provider Demographics
NPI:1902548555
Name:NEAL, WHITLEY SHANEL (CRNP, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:WHITLEY
Middle Name:SHANEL
Last Name:NEAL
Suffix:
Gender:F
Credentials:CRNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 HEARTHSIDE WAY UNIT 145
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7239
Mailing Address - Country:US
Mailing Address - Phone:323-861-2022
Mailing Address - Fax:
Practice Address - Street 1:11921 ROCKVILLE PIKE STE 400
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2757
Practice Address - Country:US
Practice Address - Phone:301-414-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR229184363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health