Provider Demographics
NPI:1144493818
Name:WHITE, STEPHANIE LANEE ROBINSON (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LANEE ROBINSON
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-653-9667
Mailing Address - Fax:
Practice Address - Street 1:UK GENERAL PEDIATRICS AT KY CLINIC SOUTH
Practice Address - Street 2:2400 GREATSTONE PT 2ND FL
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3274
Practice Address - Country:US
Practice Address - Phone:859-323-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16809208000000X
FLME109085208000000X
KY53288208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0055774-00Medicaid
FL0055774-00Medicaid