Individual
FREDISHA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6966 JACK HORNER LN, JACKSONVILLE, FL 32210-3620
(904) 437-2843
Mailing address
6966 JACK HORNER LN, JACKSONVILLE, FL 32210-3620
(904) 437-2843
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1136300600
—
FL
Enumeration date
04/14/2022
Last updated
04/14/2022
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