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Individual

MRS. TIANA WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
17 DAVID LN, LEXINGTON, SC 29073-8011
(803) 687-4904
Mailing address
17 DAVID LN, LEXINGTON, SC 29073-8011
(803) 687-4904

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
53916
SC

Other

Enumeration date
03/28/2023
Last updated
03/28/2023
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