Provider Demographics
NPI:1740372606
Name:WHITE, ROBERT (DNP, APN)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:DNP, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BLUE HERON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4077
Mailing Address - Country:US
Mailing Address - Phone:908-208-0007
Mailing Address - Fax:866-553-5184
Practice Address - Street 1:4695 HWY 9 STE 3
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3384
Practice Address - Country:US
Practice Address - Phone:732-759-8700
Practice Address - Fax:833-606-0124
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11834600363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH8426201Medicaid
NH8426201Medicaid
NJ043603Medicare ID - Type Unspecified