Provider Demographics
NPI:1669364576
Name:WHITE, NYASIA (CNM)
Entity type:Individual
Prefix:
First Name:NYASIA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3105
Mailing Address - Country:US
Mailing Address - Phone:215-909-3627
Mailing Address - Fax:
Practice Address - Street 1:433 BELLEVUE AVE FL 3
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4514
Practice Address - Country:US
Practice Address - Phone:609-394-4111
Practice Address - Fax:609-394-4070
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MM0004100367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife