1477555118 NPI number — MRS. DONNA REESMAN WHITE CRNP, FNP-BC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477555118 NPI number — MRS. DONNA REESMAN WHITE CRNP, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
DONNA
Provider Middle Name:
REESMAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP, FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477555118
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
535 BURKES DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAOPOLIS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15108-3479
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-735-3295
Provider Business Mailing Address Fax Number:
412-202-2927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 W STEUBEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRAFTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15205-2604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-825-3227
Provider Business Practice Location Address Fax Number:
412-202-2927
Provider Enumeration Date:
08/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP003061B , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 005600 . This is a "CRNP PRESCRIPTIVE AUTHORITY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: SP003061B . This is a "CRNP-FAMILY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: RN275918L . This is a "LICENSE - RN - COMMONWEALTH OF PENNSYLVANIA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01765287 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com