Healthcare Provider Details

I. General information

NPI: 1073071841
Provider Name (Legal Business Name): EMILY ROBIN WHITE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4778 S SCATTERFIELD RD
ANDERSON IN
46013-2908
US

IV. Provider business mailing address

4778 S SCATTERFIELD RD
ANDERSON IN
46013-2908
US

V. Phone/Fax

Practice location:
  • Phone: 765-646-6331
  • Fax: 317-583-2565
Mailing address:
  • Phone: 765-646-6331
  • Fax: 317-583-2565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71009015A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28179475A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: