Individual
GREGG MICHAEL WHITE
Active
Individual
GREGG MICHAEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200360037CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
097000628RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100440
—
OR
01
—
865351001
BLUE CROSS
OR
Enumeration date
06/28/2006
Last updated
08/17/2018
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