Provider Demographics
NPI:1821560921
Name:WHITE, NICOLE FRELIER (CRNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:FRELIER
Last Name:WHITE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 MAIN ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2807
Mailing Address - Country:US
Mailing Address - Phone:704-280-5612
Mailing Address - Fax:
Practice Address - Street 1:1984 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1813
Practice Address - Country:US
Practice Address - Phone:412-343-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-30
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily