Holly Lynn White, CNM
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · New York, NY
NPI 1669406450 · NPPES record last updated Nov 6, 2021
Key facts
- NPI
- 1669406450
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 403794 (NY)
- Practice address
- 274 Madison Ave RM 1501
New York, NY 10016-0701 - Phone
- (212) 203-1773
- Fax
- (646) 665-4427
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000918 | NY | MD | Behavioral Analyst |
| 403794 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rivia Medical PLLC | Current |
Accepting new patients | |
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Locations
274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773
Interoperability endpoints
- hwhite684284@nychhc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 403794 | NY | Yes |
Addresses
Primary practice location
274 Madison Ave RM 1501
New York, NY 10016-0701
Mailing address
417 Prospect PL Apt 2
Brooklyn, NY 11238-4133
Phone (718) 399-3339
Other practice location 1
227 Madison St
New York, NY 10002-7537
Phone (212) 238-7244
Other providers in New York, NY
- Halina White
- Handel White
- Harrison Nicholas White
- Harvey Lee White
- Hayley White
- Jacob White
- Jason James White
- Jay Brandon Wilson White
- Jess White
- Jessica Mary-Kathleen Ayanna White
All providers in New York, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.