Provider Demographics
NPI:1619202223
Name:WHITE, SHERECE NICOLE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHERECE
Middle Name:NICOLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE
Mailing Address - Street 2:#100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:562-435-3666
Mailing Address - Fax:562-528-5595
Practice Address - Street 1:1255 W. 15TH ST
Practice Address - Street 2:#100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7262
Practice Address - Country:US
Practice Address - Phone:888-562-5442
Practice Address - Fax:562-528-5595
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TX767740363LF0000X
TXAP118340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant