White, Nicolle E

White, Nicolle E is an individual health care provider with primary practice located at 1918 Black Rock Tpke , Fairfield CT 06825-3543. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. White, Nicolle E can be contacted via phone (203) 583-8400.

Contact Information

Primary practice address
1918 Black Rock Tpke Fairfield CT 06825-3543
Phone: (203) 583-8400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002437 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 002437 Connecticut

Profile Details

NPI number 1841500675
LBN Legal business name White, Nicolle E
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2010
Last updated Dec 2nd, 2016 - about 8 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 1841500675 NPPES
Connecticut Other 002437 LICENSE

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