MEDICARE: YAAZMIYN WHITE ARNP

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
1	363LA2200X	Adult Health Nurse Practitioner	ARNP9296298	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881130060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAAZMIYN WHITE ARNP

Provider Business Mailing Address
First Line	:	8868 MERSEYSIDE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-4355
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8868 MERSEYSIDE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-4355
Country	:	US
Telephone Number	:	904-504-6185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	01/12/2017

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Directions to “ YAAZMIYN WHITE ARNP” Practice Location

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