Basic Information
| Provider Information | |||||||||
| NPI: | 1043735335 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHITE | ||||||||
| FirstName: | BRITTNY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 WILDWOOD TRL | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356300735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2566276674 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4021 BALMORAL DR SW | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358016403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565392741 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2017 | ||||||||
| LastUpdateDate: | 08/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.