Individual
MARY A WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 363-6655
Mailing address
991 BEACH HAVEN WEST BLVD, MANAHAWKIN, NJ 08050-3812
(732) 266-3587
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NN78638
NJ
Other
Enumeration date
01/31/2023
Last updated
05/31/2023
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