Provider Demographics
NPI:1235493958
Name:WHITE, CHERYL ELAINE (RN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELAINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 FORESTEDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-5135
Mailing Address - Country:US
Mailing Address - Phone:727-480-5911
Mailing Address - Fax:727-781-3434
Practice Address - Street 1:1311 FORESTEDGE BLVD
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-5135
Practice Address - Country:US
Practice Address - Phone:727-480-5911
Practice Address - Fax:727-781-3434
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1287332163W00000X
TNRN0000162926163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse