Most Relevant Information
Provider Data
| NPI Number: | 1003316431 |
| Provider Name: | MODUPE OLUWASEYI JOLAOSO WHITE FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 0024175872 |
Most Important Dates
| Enumeration Date: | 02/12/2018 |
| Last Updated: | 08/10/2022 |
Provider Practice Location
3 RIVERSIDE CIR
ROANOKE
VA
240164955
Practice Location Phone/Fax
| Phone: | 5402245170 |
| Fax: | 5409838212 |
Provider Mailing Location
213 S JEFFERSON ST STE 1006
ROANOKE
VA
240111713
Provider Mailing Phone/Fax
| Phone: | 5402245715 |
| Fax: |