Provider Demographics
NPI:1588857387
Name:WHITE, YVETTE (NP)
Entity Type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GREEN RD
Mailing Address - Street 2:SUITE 150A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-4631
Mailing Address - Country:US
Mailing Address - Phone:734-936-4698
Mailing Address - Fax:
Practice Address - Street 1:2600 GREEN RD
Practice Address - Street 2:SUITE 150A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-4631
Practice Address - Country:US
Practice Address - Phone:734-936-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704211877363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics