Healthcare Provider Details

I. General information

NPI: 1306492806
Provider Name (Legal Business Name): ADRIANA WHITE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 CORRALES RD STE 105
CORRALES NM
87048-9347
US

IV. Provider business mailing address

261 LITTLER DR SE
RIO RANCHO NM
87124-4102
US

V. Phone/Fax

Practice location:
  • Phone: 949-820-1743
  • Fax:
Mailing address:
  • Phone: 505-506-2535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number88646
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN-72590
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: