Healthcare Provider Details

I. General information

NPI: 1033105762
Provider Name (Legal Business Name): NANCY A WHITE RN, MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 E WEST HWY ROOM 9300
SILVER SPRING MD
20910-3280
US

IV. Provider business mailing address

7018 HUNTER LN
HYATTSVILLE MD
20782-1149
US

V. Phone/Fax

Practice location:
  • Phone: 301-713-0545
  • Fax: 301-713-0379
Mailing address:
  • Phone: 301-699-8477
  • Fax: 301-713-0379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRO76486
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: