Provider Demographics
NPI:1235318601
Name:WHITE, ROSSLYN A (CNP)
Entity Type:Individual
Prefix:
First Name:ROSSLYN
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 1ST ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4750
Mailing Address - Country:US
Mailing Address - Phone:909-762-7825
Mailing Address - Fax:
Practice Address - Street 1:150 W 1ST ST
Practice Address - Street 2:SUITE 270
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4750
Practice Address - Country:US
Practice Address - Phone:909-762-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09573363LA2200X
CA19138363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health