MEDICARE: CHARLOTTE ELIZABETH 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	363A00000X	Physician Assistant	0110010231	VA

General Provider Information

NPI Number	:	1801666912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE ELIZABETH WHITE

Provider Business Mailing Address
First Line	:	1013 WOODSMANS REACH
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-8502
Country	:	US
Telephone Number	:	859-327-5959
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N CENTER DR STE 100
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-0002
Country	:	US
Telephone Number	:	757-908-3754
Fax Number	:

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

Provider Enumeration Date	:	01/09/2024
Last Update Date	:	11/18/2025

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Directions to “ CHARLOTTE ELIZABETH WHITE ” Practice Location

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