Healthcare Provider Details

I. General information

NPI: 1548416951
Provider Name (Legal Business Name): KRISTEN ROSE WHITE ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

89 HARRISON BROOK DR
BASKING RIDGE NJ
07920-2413
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5735
  • Fax:
Mailing address:
  • Phone: 908-604-2467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00024700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: