Provider Demographics
NPI:1134759970
Name:WHITE, TORI N (CNM)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:N
Last Name:WHITE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 W THOMAS RD STE 155
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-0910
Mailing Address - Country:US
Mailing Address - Phone:623-936-1780
Mailing Address - Fax:623-936-9116
Practice Address - Street 1:9305 W THOMAS RD STE 155
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-0910
Practice Address - Country:US
Practice Address - Phone:623-936-1780
Practice Address - Fax:623-936-9116
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ236628367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ236628OtherAZ STATE LICENSE