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NPI Code Detail

MEDICARE: MRS. KATRINA PATRICE WHITE RN, MSN, FNP-BC

MEDICARE: MRS. KATRINA PATRICE WHITE RN, MSN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024-170159VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10024-170159OTHERVAVA BOARD OF NURSING NURSE PRACTITIONER NUMBER

General Provider Information

NPI Number : 1104180231
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATRINA PATRICE WHITE RN, MSN, FNP-BC
Provider Business Mailing Address
First Line : 493 BLACKWELL RD STE 202
Second Line :
City : WARRENTON
State : VA
Zip : 20186-2689
Country : US
Telephone Number : 540-347-4400
Fax Number :
Provider Business Practice Location Address
First Line : 493 BLACKWELL RD STE 202
Second Line :
City : WARRENTON
State : VA
Zip : 20186-2689
Country : US
Telephone Number : 540-347-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2012
Last Update Date : 01/14/2017

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