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Individual

LAURA KELLY WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1065 OLD EKRON RD, BRANDENBURG, KY 40108-1735
(270) 422-2200
(270) 422-2221
Mailing address
1065 OLD EKRON RD, BRANDENBURG, KY 40108-1735
(270) 422-2200
(270) 422-2221

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3002841
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000305963
ANTHEM
KY
01
000000861403
ANTHEM-NSS
KY
01
158653
SIHO-NSS
KY
01
2444403000
PASSPORT ADVANTAGE
KY
01
50002937
PASSPORT
KY
01
50064974
PASSPORT-NSS
KY
05
78004108
KY
Enumeration date
07/07/2005
Last updated
08/12/2024
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