Provider Demographics
NPI:1205012697
Name:WHITE, CLARA (CRNP)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3059
Mailing Address - Fax:717-544-3638
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3059
Practice Address - Fax:717-544-3638
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP009661363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1570098OtherGATEWAY
PA50075051OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
PA793247OtherHEALTHAMERICA
PA50075051OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL