Healthcare Provider Details

I. General information

NPI: 1083528939
Provider Name (Legal Business Name): ERIC WHITE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 JEFFERSON AVE
SCRANTON PA
18510-1624
US

IV. Provider business mailing address

1607 NEWTON RANSOM BLVD
CLARKS SUMMIT PA
18411-9606
US

V. Phone/Fax

Practice location:
  • Phone: 570-770-3000
  • Fax:
Mailing address:
  • Phone: 717-419-6385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN801929
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: