| Doctor Name: | JENNILYN P. WHITTAM |
| NPI Number: | 1023339090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 336306 |
| Business Practice Address: | 1910 South Rd Poughkeepsie, NY - 126016027 |
| Business Phone Number: | 8454540120 |
| Business Fax Number: | 8454546080 |
| Mailing Address: | 1910 South Rd, POUGHKEEPSIE |
| State: | NY |
| Postal Code: | 126016027 |
| Phone Number: | 8454540120 |
| Fax Number: | 8454546080 |
| NPI Enumeration Date: | 06/14/2010 |
| NPI Last Update Date: | 09/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 336306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |