Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RO76486 | MD |
NPI | 1033105762 |
---|---|
Provider Name | Mrs. Nancy A White |
First Address | Hyattsville, MD 20782-1149 |
Second Address | Silver Spring, MD 20910-3280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 08/07/2007 |