Provider Demographics
NPI:1053462028
Name:WHITE, NORMAN N (RN)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:N
Last Name:WHITE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1568 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3216
Mailing Address - Country:US
Mailing Address - Phone:619-235-2600
Mailing Address - Fax:619-696-9573
Practice Address - Street 1:1568 6TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3216
Practice Address - Country:US
Practice Address - Phone:619-235-2600
Practice Address - Fax:619-696-9573
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426168163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse