MEDICARE: DONNA WHITE ARNP

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	363LW0102X	Women's Health Nurse Practitioner	R0078501	OK

General Provider Information

NPI Number	:	1730390642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA WHITE ARNP

Provider Business Mailing Address
First Line	:	1930 N ELM ST
Second Line	:
City	:	MIAMI
State	:	OK
Zip	:	74354-5400
Country	:	US
Telephone Number	:	918-540-2481
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 N ELM ST
Second Line	:
City	:	MIAMI
State	:	OK
Zip	:	74354-5400
Country	:	US
Telephone Number	:	918-540-2481
Fax Number	:

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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