Individual
JAPAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1014 FORSYTH ST STE 300, MACON, GA 31201-2051
(478) 633-1919
Mailing address
1014 FORSYTH ST STE 300, MACON, GA 31201-2051
(478) 633-1919
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN230667
GA
Other
Enumeration date
12/15/2016
Last updated
09/15/2020
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