Provider Demographics
NPI:1548467335
Name:WHITE, ANNA VARLEY (PA-C, MPH)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:VARLEY
Last Name:WHITE
Suffix:
Gender:F
Credentials:PA-C, MPH
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:BASILE
Other - Last Name:VARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MPH
Mailing Address - Street 1:336 FAYETTEVILLE ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-1743
Mailing Address - Country:US
Mailing Address - Phone:919-856-5657
Mailing Address - Fax:
Practice Address - Street 1:336 FAYETTEVILLE ST STE 1400
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1743
Practice Address - Country:US
Practice Address - Phone:919-856-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05116363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant