Provider Demographics
NPI:1174882674
Name:WHITE, CHICQUITA (WHNP-BC)
Entity type:Individual
Prefix:
First Name:CHICQUITA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 RIVERS RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-1069
Mailing Address - Country:US
Mailing Address - Phone:757-888-0481
Mailing Address - Fax:
Practice Address - Street 1:403 YALE DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3721
Practice Address - Country:US
Practice Address - Phone:757-826-2079
Practice Address - Fax:757-825-9165
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169749363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health