Individual provider · Type 1 NPI

Ebony Whiteside

Nurse Practitioner · Merrillville, IN

NPI number 1255200077 Active

Practice location

200 E 89th Ave
Merrillville, IN 46410-7318

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X71017385B (IN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1255200077

Ebony Whiteside's National Provider Identifier is 1255200077, issued on Oct 30, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Merrillville, IN. The record was last updated on Nov 24, 2025.