=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740372606
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT WHITE DNP, APN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 11/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4695 HWY 9 STE 3
-----------------------------------------------------
City | HOWELL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07731-3384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-759-8700
-----------------------------------------------------
Fax | 833-606-0124
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 BLUE HERON DR
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08527-4077
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-208-0007
-----------------------------------------------------
Fax | 866-553-5184
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 26NN11834600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NN11834600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------