Individual
RICKIE LEIGH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
105 IMPERIAL BLVD, BOX 2617, HENDERSONVILLE, TN 37077-3211
(615) 838-1402
Mailing address
105 IMPERIAL BLVD, BOX 2617, HENDERSONVILLE, TN 37077-3211
(615) 838-1402
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10093
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3629596
—
TN
01
—
4005023
BCBS
TN
01
—
430061614
RAILROAD MEDICARE
TN
01
—
74003138
KY MEDICAID
KY
Enumeration date
06/14/2006
Last updated
04/22/2015
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