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General NPI Number Information
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NPI Number | 1073130548
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Entity Type | Individual
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Provider Name | KELLIE ANN WHITE MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 101 11 TH STREET SE
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City | STEINHATCHEE
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State | FL
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Zip | 32359
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Country | US
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Telephone | 352-541-5503
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Fax | 352-541-0239
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Provider Business Mailing Address
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Address Line | 1400 NE STATE ROAD 47
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City | TRENTON
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State | FL
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Zip | 32693-5035
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Country | US
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Telephone | 352-538-1327
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11007811
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License Number State | FL
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