Doctor Name: | TANYA WHITE |
NPI Number: | 1003278235 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | STUDENT NP |
License Number: | RN2296060 |
Business Practice Address: | 16 Waterhouse Rd Bourne, MA - 025323897 |
Business Phone Number: | 6178007855 |
Business Fax Number: | |
Mailing Address: | 16 Waterhouse Rd, BOURNE |
State: | MA |
Postal Code: | 025323897 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/26/2016 |
NPI Last Update Date: | 03/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | RN2296060 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |