Provider Demographics
NPI:1194190058
Name:WHITE, HANNAH NICHOLS (RD)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:NICHOLS
Last Name:WHITE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:33 VILLA RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3037
Mailing Address - Country:US
Mailing Address - Phone:864-522-3128
Mailing Address - Fax:864-522-3149
Practice Address - Street 1:33 VILLA RD
Practice Address - Street 2:SUITE 420
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3037
Practice Address - Country:US
Practice Address - Phone:864-522-3128
Practice Address - Fax:864-522-3149
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1290133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered