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General NPI Number Information
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NPI Number | 1992567028
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Entity Type | Individual
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Provider Name | TROY DALE WHITE II APRN
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Gender | Male
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 608 NE 2ND AVE
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City | OKEECHOBEE
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State | FL
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Zip | 34972-2622
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Country | US
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Telephone | 863-610-1563
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Fax |
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Provider Business Mailing Address
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Address Line | 802 SW 3RD AVE
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City | OKEECHOBEE
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State | FL
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Zip | 34974-5121
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Country | US
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Telephone | 863-610-1563
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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 | APRN11030845
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN9527128
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License Number State | FL
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