Provider Demographics
NPI:1720225949
Name:WHITE, EDMOND (NP-C)
Entity type:Individual
Prefix:
First Name:EDMOND
Middle Name:
Last Name:WHITE
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CRESCENT GRN STE 102
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8117
Mailing Address - Country:US
Mailing Address - Phone:919-897-5999
Mailing Address - Fax:919-897-5980
Practice Address - Street 1:1000 CRESCENT GRN STE 102
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8117
Practice Address - Country:US
Practice Address - Phone:919-233-0410
Practice Address - Fax:919-233-0872
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC204378163W00000X
NC5004268363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner