Healthcare Provider Details

I. General information

NPI: 1114142437
Provider Name (Legal Business Name): ARLENE R WORD-WHITE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 N DETROIT ST
LAGRANGE IN
46761-1147
US

IV. Provider business mailing address

2120 N DETROIT ST
LAGRANGE IN
46761-1147
US

V. Phone/Fax

Practice location:
  • Phone: 260-463-2468
  • Fax: 260-463-4237
Mailing address:
  • Phone: 260-463-2468
  • Fax: 260-463-4237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001077A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: