Provider Demographics
NPI:1104678259
Name:WHITE, SHARLATTE
Entity type:Individual
Prefix:
First Name:SHARLATTE
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 1:3542 GERMANTOWN RD # A1
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-7323
Mailing Address - Country:US
Mailing Address - Phone:540-656-7327
Mailing Address - Fax:
Practice Address - Street 1:3542 GERMANTOWN RD # A1
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-7323
Practice Address - Country:US
Practice Address - Phone:540-656-7327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant