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General NPI Number Information
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NPI Number | 1336431550
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Entity Type | Individual
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Provider Name | TAMRA LEIGH WHITE RN
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Gender | Female
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Dates
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Enumeration Date | 05/05/2011
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 1062 ELDEN ST
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City | HERNDON
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State | VA
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Zip | 20170-3803
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Country | US
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Telephone | 703-471-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 ROWLAND DR
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City | HERNDON
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State | VA
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Zip | 20170-2430
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Country | US
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Telephone | 301-788-1529
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R145155
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License Number State | MD
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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 | 0001255433
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License Number State | VA
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