Healthcare Provider Details

I. General information

NPI: 1942977731
Provider Name (Legal Business Name): MISS APRIL DENISE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 WESTOVER HILLS BLVD APT K
RICHMOND VA
23225-4582
US

IV. Provider business mailing address

625 WESTOVER HILLS BLVD APT K
RICHMOND VA
23225-4582
US

V. Phone/Fax

Practice location:
  • Phone: 804-396-8738
  • Fax:
Mailing address:
  • Phone: 804-396-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number1401105040
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: