Provider Demographics
NPI:1679112106
Name:WHITE, AMY ALVIS (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ALVIS
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10115 E BELL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2189
Mailing Address - Country:US
Mailing Address - Phone:888-709-8721
Mailing Address - Fax:855-916-1766
Practice Address - Street 1:10115 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2189
Practice Address - Country:US
Practice Address - Phone:888-709-8721
Practice Address - Fax:855-916-1766
Is Sole Proprietor?:No
Enumeration Date:2020-01-01
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247179363LF0000X
AZRN192147163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherDONOT HAVE