Individual
TAMMY L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
210 N FRYE ST, PITTSBURG, IL 62974-1128
(618) 964-0081
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
041.276346
IL
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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