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General NPI Number Information
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NPI Number | 1275094385
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Entity Type | Individual
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Provider Name | LEONNA WHITE APRN, FNP-C, CFCS,
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Gender | Female
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 79 WAWECUS ST STE 101
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City | NORWICH
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State | CT
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Zip | 06360-2182
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Country | US
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Telephone | 860-886-2655
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Fax |
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Provider Business Mailing Address
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Address Line | 86 OTROBANDO AVE UNIT 30
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City | NORWICH
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State | CT
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Zip | 06360-2272
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Country | US
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Telephone |
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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 | 8156
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 163WG0100X
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Taxonomy Name | Gastroenterology Registered Nurse
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License Number | 10.098126
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License Number State | CT
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