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General NPI Number Information
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NPI Number | 1821345844
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Entity Type | Individual
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Provider Name | REBECCA WHITE NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2012
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1400 W SAINT GERMAIN ST
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4101
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Country | US
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Telephone | 202-976-8003
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Fax | 320-297-6700
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Provider Business Mailing Address
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Address Line | 1400 W SAINT GERMAIN ST
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4101
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Country | US
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Telephone | 320-297-6800
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Fax | 320-297-6700
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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 | R1672563
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License Number State | MN
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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 | 52
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License Number State | MN
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