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Individual
KEENON WHITE
Active
Individual
KEENON WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
26NP05281400
NJ
207Q00000X
Family Medicine Physician
Primary
C1-0012179
DE
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
02/11/2008
Last updated
07/21/2022
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