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NPI Code Detail

MEDICARE: MRS. LORA M WHITE FNP-C

MEDICARE: MRS. LORA M WHITE FNP-C
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 PractitionerAP133487TX
2164X00000XLicensed Vocational Nurse190636TX

General Provider Information

NPI Number : 1477745149
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORA M WHITE FNP-C
Provider Business Mailing Address
First Line : 7601 XAVIER DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-7638
Country : US
Telephone Number : 817-423-5140
Fax Number :
Provider Business Practice Location Address
First Line : 5900 W PLEASANT RIDGE RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76016-4427
Country : US
Telephone Number : 817-478-6041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2007
Last Update Date : 11/14/2019

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