Doctor Name: | MS. MARSHA ANN WHITE-JOHNSON |
NPI Number: | 1114908555 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP--FNP |
License Number: | 1-028925 |
Business Practice Address: | 301 Andrews Avenue Vha Wiregrass Cboc Fort Rucker, AL - 36362 |
Business Phone Number: | 3345037800 |
Business Fax Number: | |
Mailing Address: | 301 Andrews Avenue, Vha Wiregrass Cboc FORT RUCKER |
State: | AL |
Postal Code: | 36362 |
Phone Number: | 3345037800 |
Fax Number: | |
NPI Enumeration Date: | 11/11/2005 |
NPI Last Update Date: | 06/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-028925 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |