Provider Demographics
NPI:1528621075
Name:WHITE, CEAEIRA
Entity type:Individual
Prefix:
First Name:CEAEIRA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 MARSH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-2634
Mailing Address - Country:US
Mailing Address - Phone:336-907-4595
Mailing Address - Fax:336-291-8558
Practice Address - Street 1:617 MARSH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-2634
Practice Address - Country:US
Practice Address - Phone:336-907-4595
Practice Address - Fax:336-291-8558
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty