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General NPI Number Information
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NPI Number | 1225401839
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Entity Type | Individual
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Provider Name | NAKEYA S. WHITE
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Gender | Female
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 3379 PEACHTREE RD NE STE 555
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City | ATLANTA
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State | GA
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Zip | 30326-1418
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Country | US
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Telephone | 404-946-0186
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Fax | 404-946-0180
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Provider Business Mailing Address
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Address Line | 5301 FAIRINGTON CLUB DR
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City | LITHONIA
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State | GA
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Zip | 30038-5667
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Country | US
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Telephone | 404-946-0186
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Fax | 404-946-0180
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 171095LGB
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License Number State | GA
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