Provider Demographics
NPI:1336949411
Name:WHITE, LOWELL
Entity type:Individual
Prefix:
First Name:LOWELL
Middle Name:
Last Name:WHITE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 EMMERT ST APT 205
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:69360-6501
Mailing Address - Country:US
Mailing Address - Phone:308-360-2317
Mailing Address - Fax:
Practice Address - Street 1:303 EMMERT ST APT 205
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:NE
Practice Address - Zip Code:69360-6501
Practice Address - Country:US
Practice Address - Phone:308-360-2317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult Companion