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Individual

MRS. MISTY M WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
329 MCLAWS CIR, WILLIAMSBURG, VA 23185-6337
(757) 220-8579
(757) 220-0686
Mailing address
PO BOX 458, NORTH, VA 23128-0458
(757) 220-8579
(757) 220-0686

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024164785
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142097
BLUE CROSS
NJ
01
142097
ANTHEM
VA
01
1982634085
MEDICARE NPI
01
41212N
SENTARA
VA
01
541374556
CHAMPUS
VA
05
7781237
VA
Enumeration date
07/04/2006
Last updated
12/04/2020
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