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General NPI Number Information
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NPI Number | 1326342007
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Entity Type | Individual
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Provider Name | NICHOLE RENEE WHITE NP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 3536 W GLENDALE AVE
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City | PHOENIX
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State | AZ
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Zip | 85051-8395
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Country | US
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Telephone | 480-618-0177
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Fax | 620-371-2243
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Provider Business Mailing Address
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Address Line | 4390 MONTGOMERY RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6068
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Country | US
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Telephone | 410-203-1171
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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 | 255867
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R210152
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2264405
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2264405
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License Number State | MA
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