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Individual

JENNIFER SUE WHITE

Active
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Individual

JENNIFER SUE WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704231087
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4507487
—
MI
05
—
4582350
—
MI
01
—
5008702080
BLUE CROSS BLUE SHIELD
MI
01
—
P00083556
RAILROAD MEDICARE
—
Enumeration date
04/12/2006
Last updated
05/05/2021
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