Provider Demographics
NPI:1407600760
Name:WHITE, AMANDA NOELLE
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:NOELLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LAND RE WAY APT 14
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1738
Mailing Address - Country:US
Mailing Address - Phone:585-683-6368
Mailing Address - Fax:
Practice Address - Street 1:5 LAND RE WAY APT 14
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1738
Practice Address - Country:US
Practice Address - Phone:585-683-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula