White, Kelly Lynn

White, Kelly Lynn is an individual health care provider with primary practice located at 151 S 4Th St Suite 401, Grand Forks ND 58201-4715. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. White, Kelly Lynn can be contacted via phone (701) 795-3000.

Contact Information

Primary practice address
151 S 4Th St Suite 401 Grand Forks ND 58201-4715
Phone: (701) 795-3000
Fax: (701) 795-3050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1309 North Dakota

Profile Details

NPI number 1831121920
LBN Legal business name White, Kelly Lynn
Credentials Licensed Acupuncturist (LAC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jul 9th, 2007 - about 17 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 1831121920 NPPES
North Dakota MEDICAID 054519
North Dakota Other 012835
North Dakota Other 9G413JO

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