Provider Demographics
NPI:1982766721
Name:WHITE DAY, STELLA M (FNP APN)
Entity type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:M
Last Name:WHITE DAY
Suffix:
Gender:F
Credentials:FNP APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MALLARD POINT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305
Mailing Address - Country:US
Mailing Address - Phone:731-293-1020
Mailing Address - Fax:
Practice Address - Street 1:657 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3903
Practice Address - Country:US
Practice Address - Phone:731-541-8425
Practice Address - Fax:731-541-8420
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6513363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTLC35482Medicaid
Q23266Medicare UPIN
TNTLC35482Medicaid