Provider Demographics
NPI:1982032702
Name:WHITE, AIREAUTNEI (LMT, MMP)
Entity Type:Individual
Prefix:MRS
First Name:AIREAUTNEI
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:MS
Other - First Name:AIREAUTNEI
Other - Middle Name:
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT MMP
Mailing Address - Street 1:9810 LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-1379
Mailing Address - Country:US
Mailing Address - Phone:816-721-8299
Mailing Address - Fax:
Practice Address - Street 1:9810 LAWNDALE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64137-1379
Practice Address - Country:US
Practice Address - Phone:816-721-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006030988225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist