White, John

White, John is an individual health care provider with primary practice located at 215 Se 2Nd Ave , Grand Rapids MN 55744-3615. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. White, John can be contacted via phone (218) 326-1274.

Contact Information

Primary practice address
215 Se 2Nd Ave Grand Rapids MN 55744-3615
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1265822324
LBN Legal business name White, John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 28th, 2015
Last updated Jan 28th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265822324 NPPES
Minnesota MEDICAID 894755400

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