Provider Demographics
NPI:1235690454
Name:WHITE, JANNAE (DNP)
Entity Type:Individual
Prefix:DR
First Name:JANNAE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12615 SPURRIER LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5864
Mailing Address - Country:US
Mailing Address - Phone:407-235-0078
Mailing Address - Fax:
Practice Address - Street 1:1350 BLAIR DR STE F
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1333
Practice Address - Country:US
Practice Address - Phone:443-230-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002631363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health