Provider Demographics
NPI:1255945978
Name:WHITE, ANNA (CNA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 RANNELLS ACRES
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-4647
Mailing Address - Country:US
Mailing Address - Phone:304-359-5443
Mailing Address - Fax:304-359-2767
Practice Address - Street 1:85 RANNELLS ACRES
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-4647
Practice Address - Country:US
Practice Address - Phone:304-822-4097
Practice Address - Fax:304-359-2767
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant