Provider Demographics
NPI:1407853856
Name:WHITE, FRANCIS R (CRNA)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:R
Last Name:WHITE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 DANNY THOMAS PL
Mailing Address - Street 2:MS 515
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3006
Mailing Address - Fax:901-595-3842
Practice Address - Street 1:262 DANNY THOMAS PL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3006
Practice Address - Fax:901-595-3842
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47364367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200522240AMedicaid
OK100787240AMedicaid
AR124564701Medicaid
LA1982253Medicaid
ME422400000Medicaid
MO916865223Medicaid
VA010118573Medicaid
SCQAN025Medicaid
TX055033702Medicaid
MT4308226Medicaid
IA717017Medicaid
NC8052266Medicaid
MI104691991Medicaid
OH2541020Medicaid
LA1982253Medicaid
MT4308226Medicaid