Healthcare Provider Details

I. General information

NPI: 1255269528
Provider Name (Legal Business Name): THERESA ANGELL WHITE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

927 ROYAL BONNET DR
WILMINGTON NC
28405-8388
US

V. Phone/Fax

Practice location:
  • Phone: 910-667-6976
  • Fax: 910-667-4036
Mailing address:
  • Phone: 910-667-6976
  • Fax: 910-667-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number182811
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: