Individual
MRS. ELIZABETH ANN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3553 REDWOOD BLVD, SPRINGFIELD, OH 45503-5441
(937) 207-8857
Mailing address
3553 REDWOOD BLVD, SPRINGFIELD, OH 45503-5441
(937) 207-8857
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104937450599
—
OH
Enumeration date
02/05/2022
Last updated
02/05/2022
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