Provider Demographics
NPI:1033673363
Name:WHITE, KARA
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:VANDERKALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6840 LAKE MICHIGAN DR
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-8064
Mailing Address - Country:US
Mailing Address - Phone:616-895-6200
Mailing Address - Fax:
Practice Address - Street 1:6840 LAKE MICHIGAN DR
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8064
Practice Address - Country:US
Practice Address - Phone:616-895-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist