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Individual
ELISABETH A WHITE
Active
Individual
ELISABETH A 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
7012
GA
363AM0700X
Medical Physician Assistant
085.003062
IL
363AM0700X
Medical Physician Assistant
1110
TN
Other
Enumeration date
05/05/2006
Last updated
03/15/2019
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