Provider Demographics
NPI:1871287987
Name:WHITE, AMY LYNN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4199 US HIGHWAY 36 E
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-9390
Mailing Address - Country:US
Mailing Address - Phone:765-524-6642
Mailing Address - Fax:
Practice Address - Street 1:4199 US HIGHWAY 36 E
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-9390
Practice Address - Country:US
Practice Address - Phone:765-524-6642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF10201541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily