Provider Demographics
NPI:1043595648
Name:BARBARA A WHITE MSN CRNP INC
Entity Type:Organization
Organization Name:BARBARA A WHITE MSN CRNP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-509-4091
Mailing Address - Street 1:13 C ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4152
Mailing Address - Country:US
Mailing Address - Phone:301-617-2767
Mailing Address - Fax:
Practice Address - Street 1:13 C ST
Practice Address - Street 2:SUITE G
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4152
Practice Address - Country:US
Practice Address - Phone:301-617-2767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR136830363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD178901500Medicaid