Healthcare Provider Details

I. General information

NPI: 1992492946
Provider Name (Legal Business Name): LEAH ARIANE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 N DRUID HILLS RD NE
ATLANTA GA
30329-3117
US

IV. Provider business mailing address

1413 WATERFALL PKWY
TUSCALOOSA AL
35406-3288
US

V. Phone/Fax

Practice location:
  • Phone: 205-396-8525
  • Fax:
Mailing address:
  • Phone: 205-396-8525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberGAA-NP003079
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-181918
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: