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General NPI Number Information
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NPI Number | 1821473356
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Entity Type | Individual
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Provider Name | LEAH WHITE N.P.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 1325 N WEST AVE
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City | JACKSON
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State | MI
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Zip | 49202-2050
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Country | US
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Telephone | 517-768-0384
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Fax |
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Provider Business Mailing Address
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Address Line | 205 S MOSCOW RD
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City | HORTON
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State | MI
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Zip | 49246-9569
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Country | US
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Telephone | 517-740-9885
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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 | 4704268586
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License Number State | MI
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