Provider Demographics
NPI:1699073429
Name:WHITE, KATHY LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3053
Mailing Address - Country:US
Mailing Address - Phone:610-655-9961
Mailing Address - Fax:610-655-9969
Practice Address - Street 1:538 WOODWARD ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3053
Practice Address - Country:US
Practice Address - Phone:610-655-9961
Practice Address - Fax:610-655-9969
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN551755163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse