Provider Demographics
NPI:1205829173
Name:WHITE, DEBORAH ELAINE (NP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELAINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:155 HOSPITAL DR
Mailing Address - Street 2:STE 301
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2852
Mailing Address - Country:US
Mailing Address - Phone:337-232-1010
Mailing Address - Fax:337-234-3591
Practice Address - Street 1:155 HOSPITAL DR
Practice Address - Street 2:STE 301
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2852
Practice Address - Country:US
Practice Address - Phone:337-232-1010
Practice Address - Fax:337-234-3591
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2018-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN116292 AP05047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAS90416Medicare UPIN
LA3A478CR80Medicare PIN