Provider Demographics
NPI:1942246624
Name:WHITES, CONNIE SCOGIN (RNFA)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:SCOGIN
Last Name:WHITES
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 OWL CT
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2730
Mailing Address - Country:US
Mailing Address - Phone:512-923-0301
Mailing Address - Fax:512-291-6567
Practice Address - Street 1:1201 OWL CT
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2730
Practice Address - Country:US
Practice Address - Phone:512-923-0301
Practice Address - Fax:512-291-6567
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256585163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse