Provider Demographics
NPI:1457430902
Name:WHITE, SHANNON L (RNFA)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N WALDROP DR
Mailing Address - Street 2:STE. 802
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4705
Mailing Address - Country:US
Mailing Address - Phone:817-232-5086
Mailing Address - Fax:
Practice Address - Street 1:1001 N WALDROP DR
Practice Address - Street 2:STE. 802
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4705
Practice Address - Country:US
Practice Address - Phone:817-275-3309
Practice Address - Fax:817-265-0071
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX641534163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant