Healthcare Provider Details

I. General information

NPI: 1265195630
Provider Name (Legal Business Name): KATHERINE HUTCHINS WHITE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N CUTHBERT ST
COLQUITT GA
39837-3517
US

IV. Provider business mailing address

209 N CUTHBERT ST
COLQUITT GA
39837-3518
US

V. Phone/Fax

Practice location:
  • Phone: 229-758-3385
  • Fax: 229-758-2900
Mailing address:
  • Phone: 229-758-3385
  • Fax: 229-758-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN258684
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: