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General NPI Number Information
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NPI Number | 1588669378
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Entity Type | Individual
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Provider Name | ELAINE M WHITE NP
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Gender | Female
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 4600 BROADWAY
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City | SACRAMENTO
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State | CA
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Zip | 95820-1527
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Country | US
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Telephone | 916-874-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 2130 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-1337
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Country | US
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Telephone | 916-875-0701
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Fax | 916-876-5615
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 338051
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License Number State | CA
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