Provider Demographics
NPI:1346507522
Name:WHITE, VALERIE AMANDA (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:AMANDA
Last Name:WHITE
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 W 10TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1752
Mailing Address - Country:US
Mailing Address - Phone:501-661-0077
Mailing Address - Fax:501-664-2749
Practice Address - Street 1:5800 W 10TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1752
Practice Address - Country:US
Practice Address - Phone:501-661-0077
Practice Address - Fax:501-664-2749
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03674363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care