Healthcare Provider Details

I. General information

NPI: 1194635169
Provider Name (Legal Business Name): KELLY ANN WHITE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 N MAIN ST
AKRON OH
44308-1971
US

IV. Provider business mailing address

47 N MAIN ST
AKRON OH
44308-1971
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-3858
  • Fax: 330-543-3782
Mailing address:
  • Phone: 330-543-3858
  • Fax: 330-543-3782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.254313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: