Provider Demographics
NPI:1679046189
Name:WHITE, PHILIP SCOTT (NP)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:SCOTT
Last Name:WHITE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:671-B HIOAKS ROAD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4072
Mailing Address - Country:US
Mailing Address - Phone:804-272-5814
Mailing Address - Fax:804-560-0232
Practice Address - Street 1:671-B HIOAKS ROAD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4072
Practice Address - Country:US
Practice Address - Phone:804-272-5814
Practice Address - Fax:804-560-0232
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA110006456363A00000X
VA0024176879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant