Individual
JENNA MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 PAVILION RD, WEST MONROE, LA 71292-9470
(318) 512-1787
Mailing address
1902 ISLAND DR, MONROE, LA 71201-2508
(318) 512-1787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
300081
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09478866
—
MS
05
—
2410199
—
LA
Enumeration date
11/06/2015
Last updated
03/31/2016
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