Provider Demographics
NPI:1962671180
Name:WHITE, SYLVIA J (BSN)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 LANDMARK DR APT 300
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-6044
Mailing Address - Country:US
Mailing Address - Phone:435-615-3928
Mailing Address - Fax:435-615-3926
Practice Address - Street 1:6505 LANDMARK DR APT 300
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6044
Practice Address - Country:US
Practice Address - Phone:435-615-3928
Practice Address - Fax:435-615-3926
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT217995-3102163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health