CHANDRA LYNN WHITE PMHNP NPI 1558618884

NPI Information

  • NPI: 1558618884
  • Provider Name: CHANDRA LYNN WHITE, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1601 GOLF COURSE RD
    GRAND RAPIDS, MN
    ZIP 55744
  • Phone: (218) 326-3401

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NPI Details

Chandra Lynn White, PMHNP is a psychiatric/mental health nurse practitioner in Grand Rapids, MN with 14 years of experience. Chandra Lynn White, PMHNP NPI is 1558618884. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1601 GOLF COURSE RD
GRAND RAPIDS, MN
ZIP 55744-648
Phone: (218) 326-3401
Fax: (218) 999-1461

The NPI 1558618884 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 8/6/2012 and was last updated on 9/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthR160948-4MINNESOTANo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthCNP2259MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11558618884MEDICAIDWISCONSIN
21558618884MEDICAIDMICHIGAN
31558618884MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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