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Individual

AMANDA WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
7 MEDICAL PKWY, DALLAS, TX 75234-7829
(855) 677-8669
Mailing address
9101 LBJ FWY STE 710, DALLAS, TX 75243-1912
(972) 792-5700
(888) 510-3225

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95112644
CA
367500000X
Certified Registered Nurse Anesthetist
95000645
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP117593
TX
367500000X
Certified Registered Nurse Anesthetist
R217265-1
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95000645
CA BOARD OF NURSING - APRN
CA
01
95112644
CA BOARD OF NURSING- RN
CA
01
AP145878
TEXAS NURSING BOARD
TX
Enumeration date
11/08/2016
Last updated
08/19/2020
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