Provider Demographics
NPI:1992192769
Name:WHITE, TOMEKIA (NP)
Entity Type:Individual
Prefix:
First Name:TOMEKIA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:870-836-8101
Mailing Address - Fax:870-837-2329
Practice Address - Street 1:353 CASH RD SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-3704
Practice Address - Country:US
Practice Address - Phone:870-836-8101
Practice Address - Fax:870-837-2329
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA004847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201288080Medicaid
IN201288080Medicaid