Provider Demographics
NPI:1053605832
Name:WHITE, MONIQUE SHARAYE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:SHARAYE
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:670 DOWNEY GREEN ST
Mailing Address - Street 2:APARTMENT 226
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2283
Mailing Address - Country:US
Mailing Address - Phone:757-838-0162
Mailing Address - Fax:757-728-6796
Practice Address - Street 1:670 DOWNEY GREEN ST
Practice Address - Street 2:APARTMENT 226
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2283
Practice Address - Country:US
Practice Address - Phone:757-838-0162
Practice Address - Fax:757-728-6796
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0202209102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist