Healthcare Provider Details

I. General information

NPI: 1073854493
Provider Name (Legal Business Name): VIRGINIA ANN WHITE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINNY WHITE RN

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CHARLOTTE AVE
NASHVILLE TN
37209-4129
US

IV. Provider business mailing address

204 FALL ST
NASHVILLE TN
37206-1703
US

V. Phone/Fax

Practice location:
  • Phone: 615-340-7781
  • Fax: 615-340-7792
Mailing address:
  • Phone: 740-438-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number173913
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: