Doctor Name: | DARLA K WHITE |
NPI Number: | 1275883290 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 2012030915 |
Business Practice Address: | 1000 Webster Street Mexico, MO - 65265 |
Business Phone Number: | 5735812348 |
Business Fax Number: | 5735819447 |
Mailing Address: | 2111 Legend Court, JEFFERSON CITY |
State: | MO |
Postal Code: | 65101 |
Phone Number: | 5735812348 |
Fax Number: | 5735819447 |
NPI Enumeration Date: | 09/18/2012 |
NPI Last Update Date: | 12/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2012030915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |