Individual
MR. DOUGLAS WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
701 E COUNTY LINE RD STE 204, GREENWOOD, IN 46143-1071
(317) 882-0535
(317) 882-0173
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28199038A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014380A
IN
Other
Enumeration date
01/17/2023
Last updated
11/13/2023
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