SHANNA LYNN WHITE
SHANNA LYNN SOUTHWOOD · Nurse Practitioner (Family)

Address: 210 W Broadway St, Shelburn, IN 47879-1202

SHANNA LYNN WHITE (NPI# 1003369091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003369091
Entity Type Individual
Full Name SHANNA LYNN WHITE
Other Name SHANNA LYNN SOUTHWOOD (Former Name)
Gender Female
Other Credential PMHNP
Practice Address 210 W Broadway St
Shelburn
IN 47879-1202
US
Practice Telephone 8125620323
Mailing Address 210 W Broadway St
Shelburn
IN 47879-1202
US
Mailing Telephone 8125620323
Certification Date 2020-11-03
Enumeration Date 2016-07-26
Last Update Date 2021-03-23
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 363LF0000X Nurse Practitioner
Specialization: Family
71006501A IN Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
71006501A IN Physician Assistants & Advanced Practice Nursing Providers
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
2019035100 IN Physician Assistants & Advanced Practice Nursing Providers

Physician Overview

PECOS Associate Control (PAC) ID 9830486034
by Medicare Provider Enrollment and Chain/Ownership System (PECOS)
Professional Enrollment ID I20160930001351
Last Name WHITE
First Name SHANNA
Organization Legal Name VALLE VISTA LLC
Location 898 E Main St, Valle Vista Health System, Greenwood, IN 46143-1407
Graduation Year 2015
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 8224948930
Number of Group Practice Members 10

Office Location

Street Address
City SHELBURN
State IN
Zip Code 47879-1202

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1871058529 Sullivan County Internal Medicine LLC Internal Medicine 557 W Broadway St, Shelburn, IN 47879-1232 2019-02-07
1912011537 Terre Haute Pulmonary & Pediatric Clinic, LLC · Shelburn Medical Clinic Internal Medicine 557 W Broadway St, Shelburn, IN 47879-1232 2006-08-19
1326028309 Divyesh Purohit Internal Medicine 557 W Broadway, Shelburn, IN 47879 2006-01-18
1932264025 Emily Whitman Speech-Language Pathologist 5462 N County Road 200 W, Shelburn, IN 47879-8276 2006-12-27
1750361143 Kathy J Hugar Nurse Practitioner - Family 557 West Broadway, Shelburn, IN 47879 2006-01-20
1851507693 Internal Medicine Nephrology, Inc. Internal Medicine - Nephrology 557 W Broadway St, Shelburn, IN 47879-1232 2007-05-16

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750361143 Kathy J Hugar Nurse Practitioner - Family 557 West Broadway, Shelburn, IN 47879 2006-01-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407525645 Andrew Raymond Newell Nurse Practitioner - Family 5714 N Rural St, Indianapolis, IN 46220-2940 2021-09-10
1164191599 Jessica Hang · Jessica Ann Guentert Nurse Practitioner - Family 100 St Marys Epworth Xing # B100, Newburgh, IN 47630-9497 2021-09-09
1164190021 Deann Michele Sweeney Nurse Practitioner - Family 3160 W Mount Zion Rd, Salem, IN 47167-6416 2021-09-03
1467129510 Lindsey Poindexter Nurse Practitioner - Family 4550 Victory Ln, Indianapolis, IN 46203-5968 2021-08-26
1316614605 Eric Thomas Degraaf Nurse Practitioner - Family Riley Pediatrics Mooresville, 820 Samuel Moore Pkwy, Suite C, Mooresville, IN 46158 2021-08-25
1285301408 Hannah Cummins Nurse Practitioner - Family 6925 E 96th St Ste 150, Indianapolis, IN 46250-3648 2021-08-25
1023784790 Alyssa Milenbaugh Nurse Practitioner - Family 7120 Clearvista Dr Ste 400, Indianapolis, IN 46256-1621 2021-08-21
1871269829 Qing Chang Nurse Practitioner - Family 924 Lindberg Rd, West Lafayette, IN 47906-2012 2021-08-19
1265108161 Brittany Pulliam Nurse Practitioner - Family 11112 Shag Bark Trl, Carmel, IN 46032-4556 2021-08-19
1790451730 Keith A. Egly Nurse Practitioner - Family 8415 State Road 205, Churubusco, IN 46723-9234 2021-08-19
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Competitor

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City SHELBURN
Zip Code 47879

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.