Provider Demographics
NPI:1093035750
Name:WHITE, AMY ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:HERALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:140 WHITTINGTON PKWY 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4930
Mailing Address - Country:US
Mailing Address - Phone:502-327-9100
Mailing Address - Fax:855-632-8329
Practice Address - Street 1:140 WHITTINGTON PKWY 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4930
Practice Address - Country:US
Practice Address - Phone:502-327-9100
Practice Address - Fax:855-632-8329
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily