Provider Demographics
NPI:1962220384
Name:WHITE, NOAH (PA)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 LONGFELLOW DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2444
Mailing Address - Country:US
Mailing Address - Phone:517-281-2027
Mailing Address - Fax:
Practice Address - Street 1:805 S OAKLAND ST
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2253
Practice Address - Country:US
Practice Address - Phone:989-227-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant