Provider Demographics
NPI:1912603309
Name:WHITE, AMEIKA A (FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMEIKA
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20610
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-0610
Mailing Address - Country:US
Mailing Address - Phone:480-985-1093
Mailing Address - Fax:
Practice Address - Street 1:1818 E LA VIEVE LN
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3421
Practice Address - Country:US
Practice Address - Phone:325-320-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ276701207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty