Provider Demographics
NPI:1104835214
Name:WHITE, MARY PATRICIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:PATRICIA
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:7611 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2611
Mailing Address - Country:US
Mailing Address - Phone:703-658-7060
Mailing Address - Fax:703-658-3150
Practice Address - Street 1:7611 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE 108
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2611
Practice Address - Country:US
Practice Address - Phone:703-658-7060
Practice Address - Fax:703-658-3150
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024116232363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health