Healthcare Provider Details

I. General information

NPI: 1801333760
Provider Name (Legal Business Name): KATHRYN WHITE APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2017
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 BARSTOW ST NE STE B
ALBUQUERQUE NM
87111-1056
US

IV. Provider business mailing address

8236 PETROS AVE NW
ALBUQUERQUE NM
87120-3796
US

V. Phone/Fax

Practice location:
  • Phone: 505-463-2691
  • Fax:
Mailing address:
  • Phone: 505-463-2691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number80277
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number58646
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: