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General NPI Number Information
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NPI Number | 1790815827
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Entity Type | Individual
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Provider Name | JERI A WHITE RN,C
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 316 HWY 65 NORTH
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City | MARSHALL
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State | AR
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Zip | 72650
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Country | US
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Telephone | 870-448-4727
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Fax | 870-448-4496
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Provider Business Mailing Address
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Address Line | PO BOX 582
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City | LESLIE
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State | AR
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Zip | 72645-0582
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Country | US
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Telephone | 870-447-2786
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R43107
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License Number State | AR
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