Provider Demographics
NPI:1992483390
Name:WHITE, KATIE LATRICE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LATRICE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-2041
Mailing Address - Country:US
Mailing Address - Phone:513-526-9279
Mailing Address - Fax:
Practice Address - Street 1:609 TRENTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-2041
Practice Address - Country:US
Practice Address - Phone:513-526-9279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH311ZA0620X, 347C00000X, 253Z00000X, 3104A0625X, 3104A0630X, 311Z00000X, 172A00000X, 251B00000X, 171400000X, 251S00000X, 372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No347C00000XTransportation ServicesPrivate Vehicle
No253Z00000XAgenciesIn Home Supportive Care
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No172A00000XOther Service ProvidersDriver
No251B00000XAgenciesCase Management
No171400000XOther Service ProvidersHealth & Wellness Coach
No251S00000XAgenciesCommunity/Behavioral Health
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide