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General NPI Number Information
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NPI Number | 1902578669
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Entity Type | Individual
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Provider Name | WILLIAM WHITE APRN
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Gender | Male
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 1445 US HIGHWAY 51 BYP E
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City | DYERSBURG
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State | TN
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Zip | 38024-2127
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Country | US
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Telephone | 731-286-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 US HIGHWAY 51 BYP E
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City | DYERSBURG
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State | TN
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Zip | 38024-2127
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Country | US
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Telephone | 731-286-1900
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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 | 163WF0300X
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Taxonomy Name | Flight Registered Nurse
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License Number | 171289
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License Number State | TN
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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 | 30435
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License Number State | TN
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