Provider Demographics
NPI:1821578006
Name:WHITE, STEPHANIE (NP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:145 S MAIN ST STE 1C
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-7438
Mailing Address - Country:US
Mailing Address - Phone:617-553-6887
Mailing Address - Fax:617-360-3807
Practice Address - Street 1:145 S MAIN ST STE 1C
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01835-7438
Practice Address - Country:US
Practice Address - Phone:617-553-6887
Practice Address - Fax:617-360-3807
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2259156363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner