Individual
JESSICA LYNN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-1148
(304) 647-3006
Mailing address
200 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-1148
(304) 647-3006
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01471
WV
Other
Enumeration date
01/04/2011
Last updated
08/13/2014
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