Healthcare Provider Details

I. General information

NPI: 1750746178
Provider Name (Legal Business Name): LATOYA JONES WHITE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2015
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 ORLEANS ST
BALTIMORE MD
21224-1020
US

IV. Provider business mailing address

1000 NORTHSIDE DR NW APT 1552
ATLANTA GA
30318-5499
US

V. Phone/Fax

Practice location:
  • Phone: 410-558-4747
  • Fax: 410-732-0185
Mailing address:
  • Phone: 708-595-5366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number351095
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR204894
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: