Individual
TARA J WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1326 ELIDA ST, JANESVILLE, WI 53545-1810
(608) 774-8774
Mailing address
1326 ELIDA ST, JANESVILLE, WI 53545-1810
(608) 774-8774
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
164403
WI
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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