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NPI Code Detail

MEDICARE: NIKITRA WHITE

MEDICARE:   NIKITRA  WHITE
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
1101Y00000XCounselor
2171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100563256OTHERDRIVERS LICENSE

General Provider Information

NPI Number : 1841830353
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKITRA WHITE
Provider Business Mailing Address
First Line : 8326 KELWOOD AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8326 KELWOOD AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4803
Country : US
Telephone Number : 985-346-1472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2020
Last Update Date : 07/12/2022

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Directions to “ NIKITRA WHITE ” Practice Location

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