Provider Demographics
NPI:1740521582
Name:WHITE, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 SPRINGDALE RD SW
Mailing Address - Street 2:A1
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7807
Mailing Address - Country:US
Mailing Address - Phone:404-573-6020
Mailing Address - Fax:
Practice Address - Street 1:2950 SPRINGDALE RD SW
Practice Address - Street 2:A1
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7807
Practice Address - Country:US
Practice Address - Phone:404-573-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula