Provider Demographics
NPI:1801687504
Name:WHITE, ELLA JORDAN (DNP-S)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:JORDAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:DNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 E 500 S
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-3054
Mailing Address - Country:US
Mailing Address - Phone:801-698-8251
Mailing Address - Fax:
Practice Address - Street 1:10 S 2000 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5880
Practice Address - Country:US
Practice Address - Phone:801-581-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12456156-3102163WN0002X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care