Individual
MRS. MARY ELIZABETH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5100 GROOM RD, BAKER, LA 70714-3124
(225) 774-3385
(225) 774-7381
Mailing address
5100 GROOM RD, BAKER, LA 70714-3124
(225) 774-3385
(225) 774-7381
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN075477
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013412
—
LA
05
—
1191655
—
LA
01
—
1468070
WAIVER
LA
Enumeration date
11/09/2007
Last updated
11/09/2007
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