Healthcare Provider Details

I. General information

NPI: 1538022405
Provider Name (Legal Business Name): VERNETTA WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 E 87TH ST
CLEVELAND OH
44106-3434
US

IV. Provider business mailing address

PO BOX 608633
CLEVELAND OH
44108-0633
US

V. Phone/Fax

Practice location:
  • Phone: 216-972-0617
  • Fax:
Mailing address:
  • Phone: 216-972-0617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.182841.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: