Healthcare Provider Details

I. General information

NPI: 1801923057
Provider Name (Legal Business Name): JONI TERESA WHITE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23191 FRONT ST. ACCOMACK COUNTY HEALTH DEPT.
ACCOMAC VA
23301
US

IV. Provider business mailing address

28721 GARGATHA LANDING RD
PARKSLEY VA
23421-3129
US

V. Phone/Fax

Practice location:
  • Phone: 757-787-5885
  • Fax: 757-787-5841
Mailing address:
  • Phone: 757-665-4687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0017000131
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: