Individual
LISA TATARA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 626-3310
Mailing address
213 EL PASO AVE, DURHAM, NC 27703-8333
(814) 602-1622
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
257592
NC
367500000X
Certified Registered Nurse Anesthetist
257592
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
6005
NC
Other
Enumeration date
08/13/2018
Last updated
02/09/2023
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