Healthcare Provider Details

I. General information

NPI: 1003363607
Provider Name (Legal Business Name): JOANNE WHITE RDN, CSR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 ORANGE GROVE SUITE 2 PLESSEN HEALTHCARE
CHRISTIANSTED VI
00820-0000
US

IV. Provider business mailing address

1133 MEDICAL CENTER DR
WILMINGTON NC
28401-7304
US

V. Phone/Fax

Practice location:
  • Phone: 340-244-6074
  • Fax:
Mailing address:
  • Phone: 910-239-3562
  • Fax: 877-889-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberL002167
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: