Healthcare Provider Details

I. General information

NPI: 1275896771
Provider Name (Legal Business Name): DANIELLE SHARON WHITE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE SHARON WHITE

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 PINE ST SUITE102
ARCADIA LA
71001-3120
US

IV. Provider business mailing address

1285 PINE ST SUITE102
ARCADIA LA
71001-3120
US

V. Phone/Fax

Practice location:
  • Phone: 318-263-2125
  • Fax: 318-263-2009
Mailing address:
  • Phone: 318-263-2125
  • Fax: 318-263-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN095133
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: