Individual
TIESHA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 769-3495
Mailing address
329 WOODLAND AVE, FERRIDAY, LA 71334-2026
(601) 807-3341
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904883
MS
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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