Individual
TRACY ANN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
207 FOOTE AVE, JAMESTOWN, NY 14701-7077
(716) 785-5632
Mailing address
207 FOOTE AVE, JAMESTOWN, NY 14701-7077
(716) 785-5632
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2092-0210
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5845521
NYS LICENSE
NY
Enumeration date
07/22/2011
Last updated
07/22/2011
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