Provider Demographics
NPI:1518021203
Name:WHITE, TERESA B (APRN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:B
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 PINELLAS BAYWAY S
Mailing Address - Street 2:UNIT #309
Mailing Address - City:TIERRA VERDE
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1950
Mailing Address - Country:US
Mailing Address - Phone:727-446-1097
Mailing Address - Fax:727-441-2195
Practice Address - Street 1:708 DRUID RD E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3914
Practice Address - Country:US
Practice Address - Phone:727-446-1097
Practice Address - Fax:727-441-2195
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 852102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily