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General NPI Number Information
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NPI Number | 1396886834
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Entity Type | Individual
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Provider Name | TAMARA WHITE NP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5940 MERCHANT DR
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City | FLORENCE
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State | KY
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Zip | 41042-1158
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Country | US
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Telephone | 513-672-4128
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Fax | 513-672-4479
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Provider Business Mailing Address
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Address Line | 200 NORTHLAND BLVD FL 1
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City | CINCINNATI
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State | OH
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Zip | 45246-3604
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Country | US
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Telephone | 513-672-4128
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Fax | 513-672-4479
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1080720
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License Number State | KY
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