Provider Demographics
NPI:1477624294
Name:WHITE, DENISE J (APRN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-302-6565
Mailing Address - Fax:
Practice Address - Street 1:421 COMMERCIAL CT STE B
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1656
Practice Address - Country:US
Practice Address - Phone:941-244-4377
Practice Address - Fax:941-244-4376
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188218363LP0808X
TN34616363LP0808X
FLAPRN11003320363LP0808X
MI4704409517363LP0808X
OR10005315363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health