Healthcare Provider Details

I. General information

NPI: 1417625740
Provider Name (Legal Business Name): NATEKITA WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 E 7TH ST
CHARLOTTE NC
28204-6300
US

IV. Provider business mailing address

PO BOX 8544
PASADENA CA
91109-8602
US

V. Phone/Fax

Practice location:
  • Phone: 704-780-4271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: