Individual
JENNIFER WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E TRINITY PL, DECATUR, GA 30030-3302
(404) 378-2300
Mailing address
1670 TREY LN, WINDER, GA 30680-5203
(678) 283-1331
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN071603
GA
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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