Provider Demographics
NPI:1669036034
Name:WHITE, DEBORAH LYNN (DNP, MHA, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:DNP, MHA, FNP-C
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, MHA, APRN, FNPC
Mailing Address - Street 1:4855 E BROWN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8007
Mailing Address - Country:US
Mailing Address - Phone:480-219-6466
Mailing Address - Fax:480-219-6647
Practice Address - Street 1:4855 E BROWN RD STE 100
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8007
Practice Address - Country:US
Practice Address - Phone:480-219-6466
Practice Address - Fax:480-219-6647
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN189186163WE0003X
AZCNP228212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ087788Medicaid
AZCNP228212OtherAZ BOARD OF NURSING
AZRN189186OtherAZ BOARD OF NURSING