White, Elicia Nichole

White, Elicia Nichole is an individual health care provider with primary practice located at 2204 Pavilion Drive , Kingsport TN 37660. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Ambulatory Care. Pharmacy Service Providers / Ambulatory Care is her primary health care specialty. White, Elicia Nichole can be contacted via phone (423) 224-1245.

Contact Information

Primary practice address
2204 Pavilion Drive Kingsport TN 37660
Phone: (423) 224-1245
Fax: (423) 224-3901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 0202214055 Virginia
Pharmacy Service Providers / Ambulatory Care 1835P2201X 40317 Tennessee

Profile Details

NPI number 1699158543
LBN Legal business name White, Elicia Nichole
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2015
Last updated Jan 8th, 2018 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699158543 NPPES
Tennessee MEDICAID 1699158543

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