Individual
KOURTNEY ELIZABETH WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
700 E CENTER ST, DOUGLAS, WY 82633-2446
(307) 358-7359
Mailing address
700 E CENTER ST, DOUGLAS, WY 82633-2446
(307) 358-7359
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PT912
WY
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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