Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9229224 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | RN159091 | GA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN159091 | GA |
NPI | 1053649657 |
---|---|
Provider Name | Melissa Anne White |
First Address | Kingsland, GA 31548-5662 |
Second Address | Kingsland, GA 31548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2009 |
Last Update Date | 05/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00991580 | RAILROAD MEDICARE (01) | FL |