MEDICARE: PROF. DEBORAH ANN WHITE PHD, CPNP, 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
1	363LP0200X	Pediatric Nurse Practitioner	UP003219D	PA
2	363LP0200X	Pediatric Nurse Practitioner	1248722	FL
3	363LF0000X	Family Nurse Practitioner	SP010054	PA

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	:	1902800782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. DEBORAH ANN WHITE PHD, CPNP, FNP-BC

Provider Business Mailing Address
First Line	:	2354 GOLFVIEW DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-3328
Country	:	US
Telephone Number	:	412-831-1212
Fax Number	:	412-831-8587

Provider Business Practice Location Address
First Line	:	1600 CORAOPOLIS HEIGHTS RD
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-4316
Country	:	US
Telephone Number	:	412-262-2415
Fax Number	:	412-262-1537

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/24/2009

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