MEDICARE: ANGELA M WHITE

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	175T00000X	Peer Specialist		VA

General Provider Information

NPI Number	:	1316870108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M WHITE

Provider Business Mailing Address
First Line	:	26 W OLD ST # H
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-3222
Country	:	US
Telephone Number	:	804-689-0641
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 461
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-0461
Country	:	US
Telephone Number	:	804-681-0641
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/16/2026

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Directions to “ ANGELA M WHITE ” Practice Location

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