Individual
MS. ANNA MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1100 NORTH COLLEGE AVENUE, FAYETTEVILLE, AR 72703
(479) 443-4301
(479) 587-5889
Mailing address
PO BOX 9627, FAYETTEVILLE, AR 72703
(479) 422-9697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-240
AR
363AM0700X
Medical Physician Assistant
Primary
PA-240
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
710685433
TAX ID
AR
01
—
PA-240
STATE LICENSE
AR
Enumeration date
09/13/2006
Last updated
02/04/2020
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