Provider Demographics
NPI:1891675245
Name:WHITE, CAMERON TAYLOR SR
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:TAYLOR
Last Name:WHITE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-3031
Mailing Address - Country:US
Mailing Address - Phone:567-970-0942
Mailing Address - Fax:
Practice Address - Street 1:817 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-3031
Practice Address - Country:US
Practice Address - Phone:567-970-0942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider