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NPI Code Detail

MEDICARE: MRS. KENTORIA I'SHARRELL ROBERSON-WHITE NP

MEDICARE: MRS. KENTORIA I'SHARRELL ROBERSON-WHITE NP
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
1363LF0000XFamily Nurse Practitioner95015883CA

General Provider Information

NPI Number : 1275142440
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KENTORIA I'SHARRELL ROBERSON-WHITE NP
Provider Business Mailing Address
First Line : 4201 BROOK SPRING DR
Second Line :
City : DALLAS
State : TX
Zip : 75224-4968
Country : US
Telephone Number : 214-266-1400
Fax Number :
Provider Business Practice Location Address
First Line : 4922 SPRING AVE
Second Line :
City : DALLAS
State : TX
Zip : 75210-1359
Country : US
Telephone Number : 214-421-7848
Fax Number : 214-421-1119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2020
Last Update Date : 08/21/2025

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