Individual
MS. DIANE TERESA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1700 S MAIN ST, GOSHEN, IN 46526-4724
(574) 535-7474
(574) 535-7195
Mailing address
1700 S MAIN ST, GOSHEN, IN 46526-4724
(574) 535-7474
(574) 535-7195
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
70000178A
IN
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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