Provider Demographics
NPI:1073071841
Name:WHITE, EMILY ROBIN (NP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROBIN
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 JACKSON ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-4388
Mailing Address - Country:US
Mailing Address - Phone:765-646-8523
Mailing Address - Fax:
Practice Address - Street 1:2101 JACKSON ST STE 206
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-4388
Practice Address - Country:US
Practice Address - Phone:765-646-8523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28179475A163W00000X
IN71009015A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse