MEDICARE: LAURA SULLIVAN WHITE APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1-140447	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144772153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SULLIVAN WHITE APN

Provider Business Mailing Address
First Line	:	7191 CAHABA VALLEY RD STE 300
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-6461
Country	:	US
Telephone Number	:	205-405-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	7191 CAHABA VALLEY RD STE 300
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-6461
Country	:	US
Telephone Number	:	205-995-9909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2016
Last Update Date	:	03/25/2025

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Directions to “ LAURA SULLIVAN WHITE APN” Practice Location

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