Provider Demographics
NPI:1588824288
Name:WHITE, EUNICE E (RN BSN CDE)
Entity Type:Individual
Prefix:MS
First Name:EUNICE
Middle Name:E
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN BSN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1787 ALLENDALE FAIRFAX HWY
Mailing Address - Street 2:POB 218
Mailing Address - City:FAIRFAX
Mailing Address - State:SC
Mailing Address - Zip Code:29827-9133
Mailing Address - Country:US
Mailing Address - Phone:803-632-3311
Mailing Address - Fax:803-632-3565
Practice Address - Street 1:1787 ALLENDALE FAIRFAX HWY
Practice Address - Street 2:POB 218
Practice Address - City:FAIRFAX
Practice Address - State:SC
Practice Address - Zip Code:29827-9133
Practice Address - Country:US
Practice Address - Phone:803-632-3311
Practice Address - Fax:803-632-3565
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35851163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator