Provider Demographics
NPI:1790485092
Name:WHITE, CARRIE BETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:BETH
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:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:CRAIGSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24430-0081
Mailing Address - Country:US
Mailing Address - Phone:540-290-7222
Mailing Address - Fax:
Practice Address - Street 1:80 OAK ST
Practice Address - Street 2:B81
Practice Address - City:CRAIGSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24430
Practice Address - Country:US
Practice Address - Phone:540-290-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily