Healthcare Provider Details

I. General information

NPI: 1780452144
Provider Name (Legal Business Name): ABBY WHITE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 KINARD ST
NEWBERRY SC
29108-2909
US

IV. Provider business mailing address

2525 KINARD ST
NEWBERRY SC
29108-2909
US

V. Phone/Fax

Practice location:
  • Phone: 803-405-0220
  • Fax: 803-405-0222
Mailing address:
  • Phone: 803-405-0220
  • Fax: 803-405-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number28164
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: