Christy Jeanette White, ATC

Individual provider Active NPI Athletic Trainer · Zimmerman, MN

NPI 1619367018 · NPPES record last updated Jan 23, 2015

Key facts

NPI
1619367018
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2416 (MN)
Practice address
26479 Fremont Dr
Zimmerman, MN 55398-4566
Phone
(612) 229-7767
NPI assigned
Jan 23, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2416MNMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2416 MN Yes

Addresses

Primary practice location

26479 Fremont Dr
Zimmerman, MN 55398-4566

Mailing address

26479 Fremont Dr
Zimmerman, MN 55398-4566
Phone (612) 229-7767

Other providers in Zimmerman, MN

All providers in Zimmerman, MN · Athletic Trainer in Minnesota

Sources for this page

Verify at the official NPI Registry.