Individual
CHANDRA LYNN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744-8648
(218) 326-3401
(218) 999-1461
Mailing address
PO BOX 701, BUHL, MN 55713-0701
(218) 969-0386
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP2259
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R160948-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558618884
—
MI
05
—
1558618884
—
MN
05
—
1558618884
—
WI
Enumeration date
08/06/2012
Last updated
09/17/2024
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