Provider Demographics
NPI:1487693669
Name:WHITE, DONNA JOAN (PA-C)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JOAN
Last Name:WHITE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3290 N WELLNESS DR
Mailing Address - Street 2:SUITE 180 BUILDING D
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-7259
Mailing Address - Country:US
Mailing Address - Phone:616-738-4262
Mailing Address - Fax:616-738-4266
Practice Address - Street 1:3290 N WELLNESS DR
Practice Address - Street 2:SUITE 180 BUILDING D
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-7259
Practice Address - Country:US
Practice Address - Phone:616-738-4262
Practice Address - Fax:616-738-4266
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2014-03-19
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Provider Licenses
StateLicense IDTaxonomies
MI5601002835363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant