Individual
LISA JOANN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 MAIN ST, MANCHESTER, MN 56007-5004
(507) 402-3762
Mailing address
300 MAIN ST, MANCHESTER, MN 56007-5004
(507) 402-3762
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
166193-0
MN
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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