Provider Demographics
NPI:1467828590
Name:WHITE, PAIGE BRIANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:BRIANNE
Last Name:WHITE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:11945 SAN JOSE BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1627
Mailing Address - Country:US
Mailing Address - Phone:904-396-1725
Mailing Address - Fax:904-396-4893
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUITE NA1177
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-4848
Practice Address - Fax:202-877-2468
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2021-08-13
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Provider Licenses
StateLicense IDTaxonomies
FLPA9114659363A00000X
DCPA031148363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant