Provider Demographics
NPI:1477824720
Name:WHITE, COURTNEY LEIGH (MSN, CRNA)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:LEIGH
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSN, CRNA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LEIGH
Other - Last Name:SANDIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1786 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4010
Mailing Address - Country:US
Mailing Address - Phone:251-391-4516
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:MAIN BUILDING ROOM 3C38
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8145
Practice Address - Fax:415-206-6014
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA: 4156367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered