Provider Demographics
NPI:1083641104
Name:WHITE, CINDI K (ATC, EMT)
Entity Type:Individual
Prefix:
First Name:CINDI
Middle Name:K
Last Name:WHITE
Suffix:
Gender:F
Credentials:ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ALCORN DR # 493
Mailing Address - Street 2:
Mailing Address - City:ALCORN STATE
Mailing Address - State:MS
Mailing Address - Zip Code:39096-7510
Mailing Address - Country:US
Mailing Address - Phone:601-877-2483
Mailing Address - Fax:601-877-3821
Practice Address - Street 1:1000 ALCORN DR # 493
Practice Address - Street 2:
Practice Address - City:ALCORN STATE
Practice Address - State:MS
Practice Address - Zip Code:39096-7510
Practice Address - Country:US
Practice Address - Phone:601-877-2483
Practice Address - Fax:601-877-3821
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer