MEDICARE: KIRSTEN TORI WHITE ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R0049746	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508932724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN TORI WHITE ARNP

Provider Business Mailing Address
First Line	:	3450 E FRANK PHILLIPS BLVD STE 100
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2401
Country	:	US
Telephone Number	:	918-338-3777
Fax Number	:	918-338-3780

Provider Business Practice Location Address
First Line	:	3450 E FRANK PHILLIPS BLVD STE 100
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-2401
Country	:	US
Telephone Number	:	918-338-3777
Fax Number	:	918-338-3780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/26/2016

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