Individual provider Active NPI

Nicole White, BSN, RN, PHN

  • Registered Nurse
  • Marysville, CA
National Provider Identifier
1891242673
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
797568 Issued in CA
Practice address
5730 Packard Ave
Suite 100
Marysville, CA 95901-7118
Phone
(530) 749-6834
Fax
(530) 749-6397
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 797568 CA Primary

Addresses

Primary practice location

5730 Packard Ave
Suite 100
Marysville, CA 95901-7118

Mailing address

5730 Packard Ave
Suite 100
Marysville, CA 95901-7118
Phone (530) 749-6834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
797568CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1891242673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 PACKARD AVE",
            "address_2": "SUITE 100",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959017118",
            "telephone_number": "530-749-6834",
            "fax_number": "530-749-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 PACKARD AVE",
            "address_2": "SUITE 100",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959017118",
            "telephone_number": "530-749-6834",
            "fax_number": "530-749-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NICOLE",
        "credential": "BSN, RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "797568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.