MEDICARE: MRS. DANIELLE MARIE WHITE CNP

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	363LF0000X	Family Nurse Practitioner	16007	OH

General Provider Information

NPI Number	:	1659785616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE MARIE WHITE CNP

Provider Business Mailing Address
First Line	:	150 NW 70TH AVE STE 5
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2911
Country	:	US
Telephone Number	:	954-500-4526
Fax Number	:

Provider Business Practice Location Address
First Line	:	4750 N FEDERAL HWY STE 302
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-361-6866
Fax Number	:

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

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	05/19/2022

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