Healthcare Provider Details

I. General information

NPI: 1235045246
Provider Name (Legal Business Name): PATRICIA DENISE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 1ST AVE
FORT TOTTEN ND
58335-3519
US

IV. Provider business mailing address

PO BOX 359
FORT TOTTEN ND
58335-0359
US

V. Phone/Fax

Practice location:
  • Phone: 701-766-1296
  • Fax: 701-766-1815
Mailing address:
  • Phone: 701-766-1296
  • Fax: 701-766-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: