Provider Demographics
NPI:1235803362
Name:WHITE, ADRIENNE R (FNP-C)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:R
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N WEST ST APT 631
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-6194
Mailing Address - Country:US
Mailing Address - Phone:336-707-7081
Mailing Address - Fax:
Practice Address - Street 1:202 N WEST ST APT 631
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-6194
Practice Address - Country:US
Practice Address - Phone:336-707-7081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF01211053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily