Basic Information
Provider Information
NPI: 1225354038
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITE
FirstName: AINAMRIB
MiddleName: NARVAEZ
NamePrefix: MRS.
NameSuffix:  
Credential: ARNP,FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 OCEANGATE
Address2: #100
City: LONG BEACH
State: CA
PostalCode: 908024317
CountryCode: US
TelephoneNumber: 5624996191
FaxNumber: 5624996171
Practice Location
Address1: 3514 BROADWAY
Address2:  
City: RIVIERA BEACH
State: FL
PostalCode: 334042332
CountryCode: US
TelephoneNumber: 8885625442
FaxNumber: 5624996171
Other Information
ProviderEnumerationDate: 04/19/2010
LastUpdateDate: 04/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XARNP9219990FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home