Healthcare Provider Details

I. General information

NPI: 1386523959
Provider Name (Legal Business Name): LAKEDRA WHITE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 MAGNOLIA ST
GREENSBORO NC
27401-1309
US

IV. Provider business mailing address

3401 ASHFIELD CT
HIGH POINT NC
27265-8009
US

V. Phone/Fax

Practice location:
  • Phone: 336-938-0800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number700657
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number34141
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: