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General NPI Number Information
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NPI Number | 1851536015
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Entity Type | Individual
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Provider Name | JENNIFER LEIGH WHITE CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 1718 SAINT MARY ST STE A
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City | KNOXVILLE
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State | TN
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Zip | 37917-4518
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Country | US
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Telephone | 865-540-4288
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Fax | 865-637-6983
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Provider Business Mailing Address
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Address Line | 1718 SAINT MARY ST STE A
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City | KNOXVILLE
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State | TN
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Zip | 37917-4518
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Country | US
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Telephone | 865-540-4288
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Fax | 865-637-6983
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | APN0000013667
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 13667
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License Number State | TN
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