Provider Demographics
NPI:1528741303
Name:WHITE, ARTAMISE N/A (LPN)
Entity type:Individual
Prefix:
First Name:ARTAMISE
Middle Name:N/A
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ARTAMISE
Other - Middle Name:N/A
Other - Last Name:CHANNEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2116 N BOLTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-4405
Mailing Address - Country:US
Mailing Address - Phone:318-445-1250
Mailing Address - Fax:318-445-1493
Practice Address - Street 1:2116 N BOLTON AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-4405
Practice Address - Country:US
Practice Address - Phone:318-445-1250
Practice Address - Fax:318-445-1493
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA220515164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse