Stacey Renae White, AGPCNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

0024181325 Issued in VA

Practice address

3001 Hungary Spring Rd Ste C
Henrico, VA 23228-2428

Phone

(804) 415-7156

Fax

(804) 420-2854

NPI assigned

Oct 4, 2021

Last updated

Jun 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1013689363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4042 CAMBRIAN CIR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231125023",
            "telephone_number": "804-888-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HUNGARY SPRING RD STE C",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282428",
            "telephone_number": "804-415-7156",
            "fax_number": "804-420-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STACEY",
        "middle_name": "RENAE",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024181325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry L Whipple, MD FACS
• Marquita Whisonant
• Haley White
• Jetuane White
• Lisa Marie White, MSW, LCSW
• Wykinnya Whitehurst
• Leonard Brinkley Whiteside III, OD
• Christina Luckey Whitham, CCC-SLP
• Patience Andrea Whitson-Bender, BEHAVIOR TECHNICIAN
• Williams New Beginning WNB Support Services

• Adult Health Nurse Practitioner in Henrico, VA
• Providers in Henrico, VA by specialty
• Adult Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.