Provider Demographics
NPI:1386770881
Name:WHITE, LINDA WOODWARD (RN FNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:WOODWARD
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
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Mailing Address - Street 1:1611 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720
Mailing Address - Country:US
Mailing Address - Phone:706-226-1594
Mailing Address - Fax:706-272-6445
Practice Address - Street 1:1109 BURLEYSON DR SUITE 204
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720
Practice Address - Country:US
Practice Address - Phone:707-627-8162
Practice Address - Fax:706-272-6445
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN027829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00858668CMedicaid
P00307Medicare UPIN
GA00858668CMedicaid