Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | SP022057 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | SP022057 | PA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP022057 | PA |
NPI | 1003567371 |
---|---|
Provider Name | Darelle Lea White |
First Address | Pottstown, PA 19464-3527 |
Second Address | Pottstown, PA 19464-3527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2022 |
Last Update Date | 18/01/2022 |