Healthcare Provider Details

I. General information

NPI: 1508866021
Provider Name (Legal Business Name): RITA J WHITE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S OSAGE ST
CALDWELL KS
67022-1650
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE 280
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 620-845-2516
  • Fax: 620-845-2518
Mailing address:
  • Phone: 620-845-2516
  • Fax: 620-845-2518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR0061883
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44115
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: