Provider Demographics
NPI:1033427927
Name:WHITE, CAREY MARTIN (RN)
Entity Type:Individual
Prefix:MR
First Name:CAREY
Middle Name:MARTIN
Last Name:WHITE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7227 OVAR CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3460
Mailing Address - Country:US
Mailing Address - Phone:916-529-3502
Mailing Address - Fax:
Practice Address - Street 1:7227 OVAR CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-3460
Practice Address - Country:US
Practice Address - Phone:916-529-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA237194164X00000X
CA794827163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse