Provider Demographics
NPI:1396709598
Name:WHITE, BETTY W (FNP)
Entity type:Individual
Prefix:MS
First Name:BETTY
Middle Name:W
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 DEEP WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-8250
Mailing Address - Country:US
Mailing Address - Phone:828-652-8202
Mailing Address - Fax:828-652-7507
Practice Address - Street 1:100 SPAULDING RD STE 1
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-5116
Practice Address - Country:US
Practice Address - Phone:828-652-7776
Practice Address - Fax:828-652-7807
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00438202OtherRAILROAD RETIREMENT
NC201146OtherLICENSE NUMBER
NCP00438202OtherRAILROAD RETIREMENT
NCQ75287Medicare UPIN