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General NPI Number Information
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NPI Number | 1629866488
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Entity Type | Individual
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Provider Name | MICHELE DAWN WHITE RN
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Gender | Female
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 4605 MACCORKLE AVE SW
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-1311
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Country | US
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Telephone | 304-766-4350
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Fax | 304-766-4355
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Provider Business Mailing Address
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Address Line | 970 KELLYS CREEK RD
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City | HURRICANE
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State | WV
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Zip | 25526-5972
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Country | US
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Telephone | 681-587-8693
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Fax | 681-587-8693
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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 | 72989
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License Number State | WV
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