White, Dedrea A
White, Dedrea A is an individual health care provider with primary practice located at 7 Shackleford West Blvd , Little Rock AR 72211-3714. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. White, Dedrea A can be contacted via phone (501) 664-5860.Contact Information
Primary practice address
7 Shackleford West Blvd
Little Rock AR 72211-3714
Phone: (501) 664-5860
Fax: (501) 664-0889
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | A01751 | Arkansas |
Profile Details
NPI number | 1639163736 |
---|---|
LBN Legal business name | White, Dedrea A |
Credentials | Adult Nurse Practitioner (ANP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 2nd, 2005 |
Last updated | Feb 25th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639163736 | NPPES |
Arkansas | MEDICAID | 159173758 |
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