Provider Demographics
NPI:1720730781
Name:WHITE, MICHELE (RN-BC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 COTTAGE RD
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-3928
Mailing Address - Country:US
Mailing Address - Phone:207-931-8115
Mailing Address - Fax:
Practice Address - Street 1:11 CALDWELL RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5739
Practice Address - Country:US
Practice Address - Phone:207-213-2037
Practice Address - Fax:207-621-1107
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER038899163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health