Provider Demographics
NPI:1366870933
Name:WHITE, VIRGINIA C (RN)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:C
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VIRGINA
Other - Middle Name:GLENN
Other - Last Name:CROWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301-A PALMETTO PARK, BOULEVARD
Mailing Address - Street 2:LEXINGTON COUNTY COMMUNITY MENTAL HEALTH CENTER
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072
Mailing Address - Country:US
Mailing Address - Phone:803-359-3545
Mailing Address - Fax:803-359-2111
Practice Address - Street 1:301-A PALMETTO PARK BOULEVARD
Practice Address - Street 2:LEXINGTON COUNTY COMMUNITY MENTAL HEALTH CENTER
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072
Practice Address - Country:US
Practice Address - Phone:803-359-3545
Practice Address - Fax:803-359-2111
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37218163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult