Provider Demographics
NPI:1487247821
Name:WHITE, CASEY DANIELLE (APRN)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:DANIELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:D
Other - Last Name:CROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:611 W PARK
Mailing Address - Street 2:FAPC
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61636-0001
Mailing Address - Country:US
Mailing Address - Phone:309-556-8300
Mailing Address - Fax:
Practice Address - Street 1:1302 FRANKLIN AVE STE 4500
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3593
Practice Address - Country:US
Practice Address - Phone:309-556-8300
Practice Address - Fax:309-556-8293
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022758364SA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute CareGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty