Healthcare Provider Details

I. General information

NPI: 1396264776
Provider Name (Legal Business Name): TAWNA FARLEY WHITE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2017
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 KANAWHA TER
SAINT ALBANS WV
25177-2750
US

IV. Provider business mailing address

2 PINEWOOD CIR
SAINT ALBANS WV
25177-9745
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-6999
  • Fax: 304-205-1135
Mailing address:
  • Phone: 304-757-6999
  • Fax: 304-205-1135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN68309NP
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number68309
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: