Provider Demographics
NPI:1730598012
Name:WHITE, JE'PURDE (PHARMD)
Entity type:Individual
Prefix:
First Name:JE'PURDE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10692 CAMPUS WAY S
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10692 CAMPUS WAY S
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:MD
Practice Address - Zip Code:20774-1307
Practice Address - Country:US
Practice Address - Phone:301-386-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22482183500000X
DCPH100001747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist