Provider Demographics
NPI:1871665620
Name:WHITE, VIVIAN DELOIS (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:DELOIS
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 JESSE HILL JR DRIVE SE
Mailing Address - Street 2:ROOM 402
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-730-1211
Mailing Address - Fax:
Practice Address - Street 1:3201 ATLANTA INDUSTRIAL PARKWAY
Practice Address - Street 2:CENTER HILL HEALTH CENTER SUITE 302
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331
Practice Address - Country:US
Practice Address - Phone:404-699-6370
Practice Address - Fax:404-505-5725
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN065487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse