Provider Demographics
NPI:1215663927
Name:WHITE, ANN MARIE (FNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 US HIGHWAY 158 W
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-8304
Mailing Address - Country:US
Mailing Address - Phone:336-694-9331
Mailing Address - Fax:336-694-7511
Practice Address - Street 1:250 W KINGS HWY
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5010
Practice Address - Country:US
Practice Address - Phone:336-864-2795
Practice Address - Fax:336-694-7511
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001261845163W00000X
NC5016790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse