Individual
EBONY WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E 89TH AVE, MERRILLVILLE, IN 46410-7318
(219) 644-3957
Mailing address
200 E 89TH AVE, MERRILLVILLE, IN 46410-7318
(219) 779-0011
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71017385B
IN
Other
Enumeration date
10/30/2025
Last updated
11/24/2025
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