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General NPI Number Information
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NPI Number | 1922971761
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Entity Type | Individual
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Provider Name | STACEY-ANN ALICIA WHITE APRN
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Gender | Female
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1351 WHALLEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06515-1149
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Country | US
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Telephone | 929-530-1514
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Fax |
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Provider Business Mailing Address
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Address Line | 61 GRANFIELD AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06610-2301
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Country | US
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Telephone | 929-530-1514
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12.014962
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License Number State | CT
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