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General NPI Number Information
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NPI Number | 1386250348
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Entity Type | Organization
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Legal Business Name | JESSICA M WHITE, ARNP, INC
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 2607 BRIDGEPORT WAY W STE 2E
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4725
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Country | US
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Telephone | 818-263-4362
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Fax | 206-567-1928
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Provider Business Mailing Address
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Address Line | 2607 BRIDGEPORT WAY W STE 2E
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4725
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Country | US
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Telephone | 818-263-4362
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Fax | 206-567-1928
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | JESSICA MORGAN WHITE
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Credential | ARNP
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Telephone | 818-263-4362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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