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Individual

JEREMY SHAUN WHITED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
940 E LEE HWY, CHILHOWIE, VA 24319-3237
(276) 880-5629
Mailing address
334 CARTER ST, BLUFF CITY, TN 37618-2922
(276) 880-5629

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024190211
VA
363LF0000X
Family Nurse Practitioner
36403
TN

Other

Enumeration date
05/15/2024
Last updated
11/05/2024
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