Provider Demographics
NPI:1487211629
Name:WHITE, KATHERINE BAKER (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:BAKER
Last Name:WHITE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:KATHERINE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2616 W CREEK DR SE
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35741-8801
Mailing Address - Country:US
Mailing Address - Phone:256-777-2814
Mailing Address - Fax:
Practice Address - Street 1:101 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4421
Practice Address - Country:US
Practice Address - Phone:256-265-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL126264367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered