Provider Demographics
NPI:1316503253
Name:WHITE, HEATHER (RN, BSN, CSN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN, BSN, CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FREDONIA RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-7901
Mailing Address - Country:US
Mailing Address - Phone:724-588-2500
Mailing Address - Fax:724-588-5036
Practice Address - Street 1:60 FREDONIA RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-7901
Practice Address - Country:US
Practice Address - Phone:724-588-2500
Practice Address - Fax:724-588-5036
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN530652L163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000000OtherSCHOOL- NO INSURANCES