Provider Demographics
NPI:1093853889
Name:WHITE, ANNA T (FNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:T
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11312 US 15 501 HWY N
Mailing Address - Street 2:SUITE 308
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-6375
Mailing Address - Country:US
Mailing Address - Phone:919-960-6094
Mailing Address - Fax:
Practice Address - Street 1:11312 US 15 501 HWY N
Practice Address - Street 2:SUITE 308
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-6375
Practice Address - Country:US
Practice Address - Phone:919-960-6094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200901363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000264Medicaid
NC7000264Medicaid
NC2596817Medicare PIN