Individual
SUSANNAH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4111 BEN FRANKLIN BLVD, DURHAM, NC 27704-2141
(919) 782-3456
Mailing address
4111 BEN FRANKLIN BLVD, DURHAM, NC 27704-2141
(919) 782-3456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03439
NC
363AM0700X
Medical Physician Assistant
Primary
0010-03439
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NC7589A
MEDICARE
NC
Enumeration date
04/27/2012
Last updated
02/18/2014
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