Provider Demographics
NPI:1245513704
Name:WHITE, DAPHNE ROXAN (RPH)
Entity type:Individual
Prefix:MS
First Name:DAPHNE
Middle Name:ROXAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6904 E WHIRLAWAY CT
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9813
Mailing Address - Country:US
Mailing Address - Phone:609-221-2847
Mailing Address - Fax:
Practice Address - Street 1:1149 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8798
Practice Address - Country:US
Practice Address - Phone:336-584-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19566183500000X
NJ28RI02624900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist