Healthcare Provider Details

I. General information

NPI: 1588960215
Provider Name (Legal Business Name): JOYCE JULIA WHITE FNP, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S PRICE AVE
HOMINY OK
74035-2524
US

IV. Provider business mailing address

PO BOX 1784
BENTONVILLE AR
72712-1784
US

V. Phone/Fax

Practice location:
  • Phone: 918-885-1264
  • Fax: 918-885-1265
Mailing address:
  • Phone: 479-268-3477
  • Fax: 479-268-3478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number418908
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberN0062601
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: