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General NPI Number Information
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NPI Number | 1548816044
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Entity Type | Organization
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Legal Business Name | WHITES FAMILY CLINIC LLC
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 418 N 2ND ST
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City | ASHDOWN
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State | AR
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Zip | 71822-2755
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Country | US
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Telephone | 870-898-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 418 N 2ND ST
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City | ASHDOWN
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State | AR
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Zip | 71822-2755
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Country | US
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Telephone | 870-898-0002
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Fax |
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Authorized Official
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Title or Position | ADVANCED PRACTICE REGISTERED NURSE
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Name | CORTNEY LINDSEY WHITE
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Credential | APRN
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Telephone | 870-898-0002
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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 |
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License Number State |
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