Provider Demographics
NPI:1700181203
Name:WHITE, SAQUEEN (LPN)
Entity type:Individual
Prefix:MS
First Name:SAQUEEN
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CHAUNCEY ST APT 4G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1832
Mailing Address - Country:US
Mailing Address - Phone:347-645-8203
Mailing Address - Fax:347-425-9788
Practice Address - Street 1:120 CHAUNCEY ST APT 4G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1832
Practice Address - Country:US
Practice Address - Phone:347-645-8203
Practice Address - Fax:347-425-9788
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303646164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse