Provider Demographics
NPI:1780690545
Name:WHITE, KARA M (FNP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP
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 192
Mailing Address - Street 2:
Mailing Address - City:NORTH CARROLLTON
Mailing Address - State:MS
Mailing Address - Zip Code:38947-0192
Mailing Address - Country:US
Mailing Address - Phone:662-237-4525
Mailing Address - Fax:662-237-9781
Practice Address - Street 1:502 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NORTH CARROLLTON
Practice Address - State:MS
Practice Address - Zip Code:38947
Practice Address - Country:US
Practice Address - Phone:662-237-4525
Practice Address - Fax:662-237-9781
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR852957363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSR852957OtherSTATE LICENSE