Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | WHIT-TOGHY | NC |
NPI | 1003574765 |
---|---|
Provider Name | Mr. Brian Anthony White |
First Address | High Point, NC 27265-1267 |
Second Address | Greensboro, NC 27410-5167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |