Provider Demographics
NPI:1609261452
Name:WHITE, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:MC COOL JUNCTION
Mailing Address - State:NE
Mailing Address - Zip Code:68401-0066
Mailing Address - Country:US
Mailing Address - Phone:402-366-1309
Mailing Address - Fax:
Practice Address - Street 1:2222 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-1030
Practice Address - Country:US
Practice Address - Phone:402-362-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1202225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant