Provider Demographics
NPI:1912470832
Name:WHITE, REBECCA JANEEN (NP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANEEN
Last Name:WHITE
Suffix:
Gender:F
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 1:40060 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:OH
Mailing Address - Zip Code:43719-9763
Mailing Address - Country:US
Mailing Address - Phone:740-782-0092
Mailing Address - Fax:
Practice Address - Street 1:40060 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:OH
Practice Address - Zip Code:43719-9763
Practice Address - Country:US
Practice Address - Phone:740-526-0204
Practice Address - Fax:740-912-2951
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.392876163W00000X
WV86689163W00000X
OH025168363LF0000X, 363LP0808X
WV105770363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily