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Individual
JENNA MARIE WHITE
Active
Individual
JENNA MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
300081
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09478866
—
MS
05
—
2410199
—
LA
Enumeration date
11/06/2015
Last updated
03/31/2016
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