Provider Demographics
NPI:1275158925
Name:WHITE, MAKAYLA LYNN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24096 WALDEN RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-7712
Mailing Address - Country:US
Mailing Address - Phone:276-596-4608
Mailing Address - Fax:
Practice Address - Street 1:322 VALLEY ST NE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2912
Practice Address - Country:US
Practice Address - Phone:276-628-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179233363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner