Provider Demographics
NPI:1316290265
Name:WHITE, MARY ELIZABETH (RPN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:WHITE
Suffix:
Gender:F
Credentials:RPN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20 LANCASTER CT
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3849
Mailing Address - Country:US
Mailing Address - Phone:187-746-9176
Mailing Address - Fax:845-445-6695
Practice Address - Street 1:259 N MIDDLETOWN RD
Practice Address - Street 2:SUITE D
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1220
Practice Address - Country:US
Practice Address - Phone:187-746-9176
Practice Address - Fax:845-445-6695
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267869-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health