Most Relevant Information
Provider Data
| NPI Number: | 1003369091 |
| Provider Name: | SHANNA LYNN WHITE |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 71006501A |
Most Important Dates
| Enumeration Date: | 07/26/2016 |
| Last Updated: | 03/23/2021 |
Provider Practice Location
210 W BROADWAY ST
SHELBURN
IN
478791202
Practice Location Phone/Fax
| Phone: | 8125620323 |
| Fax: |
Provider Mailing Location
210 W BROADWAY ST
SHELBURN
IN
478791202
Provider Mailing Phone/Fax
| Phone: | 8125620323 |
| Fax: |