Provider Demographics
NPI:1487662367
Name:WHITE, KAREN L (RN CMT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN CMT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:5409 EVERYBODYS ROAD
Mailing Address - City:CRANDON
Mailing Address - State:WI
Mailing Address - Zip Code:54520
Mailing Address - Country:US
Mailing Address - Phone:715-478-4300
Mailing Address - Fax:715-478-4490
Practice Address - Street 1:232 S COURTNEY ST
Practice Address - Street 2:RIVERWALK CENTRE
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3319
Practice Address - Country:US
Practice Address - Phone:715-362-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1884046225700000X
WI57518030163W00000X
MI47084723163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163W00000XNursing Service ProvidersRegistered Nurse