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General NPI Number Information
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NPI Number | 1376819748
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Entity Type | Individual
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Provider Name | JANAE HARRIS WHITE FNP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 110 N JERRY CLOWER BLVD SUITE M
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City | YAZOO CITY
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State | MS
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Zip | 39194-5144
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Country | US
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Telephone | 662-746-8962
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Fax | 662-746-8964
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Provider Business Mailing Address
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Address Line | PO BOX 245
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City | FLORA
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State | MS
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Zip | 39071-0245
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Country | US
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Telephone | 601-573-9584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R882972
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License Number State | MS
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