Healthcare Provider Details

I. General information

NPI: 1043962608
Provider Name (Legal Business Name): KRISTINA SLINKER-WHITE AS, CAPRC II-MH, CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3171 N MERIDIAN ST
INDIANAPOLIS IN
46208-4784
US

IV. Provider business mailing address

339 LACLEDE ST
INDIANAPOLIS IN
46241-0715
US

V. Phone/Fax

Practice location:
  • Phone: 317-601-3682
  • Fax:
Mailing address:
  • Phone: 317-439-8728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: