Doctor Name: | MRS. ANGELA J WHITE |
NPI Number: | 1114277944 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 1-074021 |
Business Practice Address: | 5009 Riverchase Dr Suite 500 Phenix City, AL - 368677490 |
Business Phone Number: | 3344489505 |
Business Fax Number: | 3344489575 |
Mailing Address: | 5009 Riverchase Dr, Suite 500 PHENIX CITY |
State: | AL |
Postal Code: | 368677490 |
Phone Number: | 3344489505 |
Fax Number: | 3344489575 |
NPI Enumeration Date: | 09/19/2012 |
NPI Last Update Date: | 09/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-074021 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |