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Individual

DEIDRA WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
148 BILL CARRUTH PKWY STE 220, HIRAM, GA 30141-3756
(770) 505-0023
Mailing address
148 BILL CARRUTH PKWY STE 220, HIRAM, GA 30141-3756
(775) 505-0023

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
117058
GA
363LF0000X
Family Nurse Practitioner
RN 117058 NP
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00810917B
GA
Enumeration date
03/14/2007
Last updated
10/10/2025
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