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General NPI Number Information
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NPI Number | 1447486360
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Entity Type | Individual
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Provider Name | TRACY ANN WHITE CNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 3535 OLENTANGY RIVER RD
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City | COLUMBUS
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State | OH
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Zip | 43214-3908
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Country | US
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Telephone | 614-566-3374
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Fax |
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Provider Business Mailing Address
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Address Line | 54 PURPLE FINCH LOOP
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City | PATASKALA
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State | OH
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Zip | 43062-8947
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Country | US
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Telephone | 740-964-0840
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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 | COA.10833-NP
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License Number State | OH
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