Provider Demographics
NPI:1003574765
Name:WHITE, BRIAN ANTHONY (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:WHITE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 TANGLEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1267
Mailing Address - Country:US
Mailing Address - Phone:336-906-0757
Mailing Address - Fax:
Practice Address - Street 1:445 DOLLEY MADISON RD STE 410
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5167
Practice Address - Country:US
Practice Address - Phone:336-292-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCWHIT-TOGHY363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health