Individual
MR. TED ALLAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP-BC
Contact information
Practice address
410 N STATE OF FRANKLIN RD, SUITE 130, JOHNSON CITY, TN 37604-6971
(423) 431-2477
(423) 431-2478
Mailing address
410 N STATE OF FRANKLIN RD, SUITE 130, JOHNSON CITY, TN 37604-6971
(423) 431-2477
(423) 431-2478
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
16367
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134497787
—
NC
05
—
1134497787
—
VA
05
—
1527289
—
TN
05
—
7100214350
—
KY
Enumeration date
12/12/2011
Last updated
02/28/2017
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