Provider Demographics
NPI:1629633730
Name:WHINNERY, CHANCE TYP (MD)
Entity type:Individual
Prefix:
First Name:CHANCE
Middle Name:TYP
Last Name:WHINNERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 JOHN DANTIS RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87151-0100
Mailing Address - Country:US
Mailing Address - Phone:505-839-8834
Mailing Address - Fax:
Practice Address - Street 1:100 JOHN DANTIS RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87151-0100
Practice Address - Country:US
Practice Address - Phone:505-839-8834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2024-11402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry