Individual
DR. ELICIA NICHOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2204 PAVILION DRIVE, KINGSPORT, TN 37660
(423) 224-1245
(423) 224-3901
Mailing address
2204 PAVILION DRIVE, KINGSPORT, TN 37660
(423) 224-1245
(423) 224-3901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202214055
VA
1835P2201X
Ambulatory Care Pharmacist
Primary
40317
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699158543
—
TN
Enumeration date
07/09/2015
Last updated
01/08/2018
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