Provider Demographics
NPI:1578456307
Name:WHITNEY, STUART MICHAEL SR
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:MICHAEL
Last Name:WHITNEY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 N 80TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-2024
Mailing Address - Country:US
Mailing Address - Phone:402-690-6916
Mailing Address - Fax:
Practice Address - Street 1:5702 N 80TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-2024
Practice Address - Country:US
Practice Address - Phone:402-690-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor