Provider Demographics
NPI:1922030600
Name:SMITH-WHITE, AMY L (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:SMITH-WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 SENATE BLVD
Mailing Address - Street 2:# 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1228
Mailing Address - Country:US
Mailing Address - Phone:317-802-2000
Mailing Address - Fax:317-924-0115
Practice Address - Street 1:1801 SENATE BLVD
Practice Address - Street 2:# 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-802-2000
Practice Address - Fax:317-924-0115
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28093571163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse