Individual
JENNA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1852 VALMONT ST, MANDEVILLE, LA 70448-3857
(512) 963-1635
Mailing address
1852 VALMONT ST, MANDEVILLE, LA 70448-3857
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2022019007
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209026788
IL
Other
Enumeration date
03/19/2020
Last updated
02/10/2023
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