Individual
KELLI WHITE DART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN103706
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN103706
RN LICENSE
LA
Enumeration date
05/10/2019
Last updated
05/10/2019
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