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General NPI Number Information
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NPI Number | 1306728498
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Entity Type | Individual
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Provider Name | DYLAN WHITE EMT-P
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Gender | Male
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 8450 SHANER AVE NE
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City | ROCKFORD
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State | MI
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Zip | 49341-9379
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Country | US
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Telephone | 616-214-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 1654 SALISBURY
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City | LOWELL
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State | MI
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Zip | 49331-8847
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Country | US
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Telephone | 616-214-1900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 2011816
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License Number State | MI
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