Provider Demographics
NPI:1578173647
Name:WHITE, HONEY
Entity Type:Individual
Prefix:
First Name:HONEY
Middle Name:
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 1:380 ENTERPRISE DR APT 301
Mailing Address - Street 2:
Mailing Address - City:GASSAWAY
Mailing Address - State:WV
Mailing Address - Zip Code:26624-7908
Mailing Address - Country:US
Mailing Address - Phone:304-982-0258
Mailing Address - Fax:
Practice Address - Street 1:380 ENTERPRISE DR APT 301
Practice Address - Street 2:
Practice Address - City:GASSAWAY
Practice Address - State:WV
Practice Address - Zip Code:26624-7908
Practice Address - Country:US
Practice Address - Phone:304-982-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant