Provider Demographics
NPI:1780295667
Name:WHITE, SHARNICE LETIA (APRN)
Entity type:Individual
Prefix:
First Name:SHARNICE
Middle Name:LETIA
Last Name:WHITE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:SHARNICE
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:11751 LAKE BEND CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-9057
Mailing Address - Country:US
Mailing Address - Phone:904-422-1712
Mailing Address - Fax:
Practice Address - Street 1:11751 LAKE BEND CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-9057
Practice Address - Country:US
Practice Address - Phone:904-422-1712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008373363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health