IndividualActive
Ida White, PA
NPI 1154882538 · Medical Physician Assistant · Providence, RI
Provider details
- NPI number
- 1154882538
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- PA01458 (RI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
164 Summit Ave
Providence, RI 02906
Phone: (401) 793-4102
Fax: (401) 793-4049
Approximate (ZIP-level) locationGet directions
Mailing address
117 Ellenfield St Ste 101
Providence, RI 02905-4541
Registry dates
- Enumerated
- 2019-03-27
- Last updated
- 2022-06-21
- Certified
- 2022-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.