Provider Demographics
NPI:1154751659
Name:WHITE, DONNA (APN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 N LOCUST AVE
Mailing Address - Street 2:STE B
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3516
Mailing Address - Country:US
Mailing Address - Phone:931-762-9797
Mailing Address - Fax:931-762-9798
Practice Address - Street 1:110 WEAKLEY CREEK RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2238
Practice Address - Country:US
Practice Address - Phone:931-766-5001
Practice Address - Fax:931-762-3800
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily