Provider Demographics
NPI:1992409338
Name:WHITE, MELEICE ANTOINETTE
Entity type:Individual
Prefix:MS
First Name:MELEICE
Middle Name:ANTOINETTE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 Q ST SE APT 205
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5406
Mailing Address - Country:US
Mailing Address - Phone:202-749-9188
Mailing Address - Fax:
Practice Address - Street 1:903 JACKSON ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3413
Practice Address - Country:US
Practice Address - Phone:202-277-1657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant