Provider Demographics
NPI:1851649933
Name:WHITE, RIENEKE D (FNP-BC, CNM)
Entity Type:Individual
Prefix:
First Name:RIENEKE
Middle Name:D
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP-BC, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2128
Mailing Address - Country:US
Mailing Address - Phone:541-709-5338
Mailing Address - Fax:541-709-5339
Practice Address - Street 1:1076 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2128
Practice Address - Country:US
Practice Address - Phone:541-709-5338
Practice Address - Fax:541-709-5339
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID66160363LF0000X
OR201508015NP-PP367A00000X
IDCNM-63A367A00000X
OR202002624NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife