Individual
MRS. CAROL ANN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, ANPC, RN, GNPC,
Contact information
Practice address
6439 N CLEAR CREEK RD, HUNTINGTON, IN 46750-8893
(260) 224-6161
Mailing address
6439 N CLEAR CREEK RD, HUNTINGTON, IN 46750-8893
(260) 224-6161
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001032A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71001032A
IN
363LG0600X
Gerontology Nurse Practitioner
71001032B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283474
ANTHEM
—
05
—
200312050A
—
IN
05
—
201263600
—
IN
01
—
P00016928
MEDICARE RAILROAD
—
Enumeration date
01/11/2006
Last updated
05/29/2015
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