Provider Demographics
NPI:1114142437
Name:WORD-WHITE, ARLENE R (NP-C)
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:R
Last Name:WORD-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 1:2120 N DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:IN
Mailing Address - Zip Code:46761-1147
Mailing Address - Country:US
Mailing Address - Phone:260-463-2468
Mailing Address - Fax:260-463-4237
Practice Address - Street 1:2120 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:IN
Practice Address - Zip Code:46761-1147
Practice Address - Country:US
Practice Address - Phone:260-463-2468
Practice Address - Fax:260-463-4237
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001077A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily