Provider Demographics
NPI:1235647967
Name:WHITE, ALECIA VANEE' (APRN,FNP-C,PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:VANEE'
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN,FNP-C,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-7502
Mailing Address - Country:US
Mailing Address - Phone:615-293-7985
Mailing Address - Fax:
Practice Address - Street 1:5810 SHELBY OAKS DR STE B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7315
Practice Address - Country:US
Practice Address - Phone:615-673-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23634363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily