Individual
ELIZABETH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
5909 U S HIGHWAY 49, SUITE 30, HATTIESBURG, MS 39402-2860
(601) 296-2780
(601) 296-2781
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 296-2780
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R871182
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
871182
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06986397
—
MS
Enumeration date
06/15/2006
Last updated
07/24/2020
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