Provider Demographics
NPI:1366686768
Name:WHITE, ERNESTINE PAIGE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ERNESTINE
Middle Name:PAIGE
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 753
Mailing Address - Street 2:
Mailing Address - City:KENDLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77451-0753
Mailing Address - Country:US
Mailing Address - Phone:979-253-0288
Mailing Address - Fax:
Practice Address - Street 1:400 ELMVIEW
Practice Address - Street 2:
Practice Address - City:POWELLPOINT
Practice Address - State:TX
Practice Address - Zip Code:77451
Practice Address - Country:US
Practice Address - Phone:979-253-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX574143163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health