Healthcare Provider Details

I. General information

NPI: 1518335041
Provider Name (Legal Business Name): KORIN WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 HERON POINT RD
ALTON NH
03809-5023
US

IV. Provider business mailing address

48 HERON POINT RD
ALTON NH
03809-5023
US

V. Phone/Fax

Practice location:
  • Phone: 603-859-3635
  • Fax:
Mailing address:
  • Phone: 603-859-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number09613
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: