Provider Demographics
NPI:1457631053
Name:WHITE, FELICIA NORRIS (FNP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:NORRIS
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-3217
Mailing Address - Country:US
Mailing Address - Phone:662-335-3991
Mailing Address - Fax:662-332-1736
Practice Address - Street 1:1414 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701
Practice Address - Country:US
Practice Address - Phone:662-335-3991
Practice Address - Fax:662-332-1736
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR860151363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily