Provider Demographics
NPI:1366545477
Name:WHITE, GLORIA J (NP)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2472 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6951 WILLIAMS RD
Practice Address - Street 2:PLANNED PARENTHOOD
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-3022
Practice Address - Country:US
Practice Address - Phone:716-205-0704
Practice Address - Fax:716-205-0710
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4202201363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00056053306OtherBCBS
9512637OtherIHA
P17379Medicare UPIN