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Individual

REBECCA WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1400 W SAINT GERMAIN ST, SAINT CLOUD, MN 56301-4101
(202) 976-8003
(320) 297-6700
Mailing address
1400 W SAINT GERMAIN ST, SAINT CLOUD, MN 56301-4101
(320) 297-6800
(320) 297-6700

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R1672563
MN
363LF0000X
Family Nurse Practitioner
Primary
52
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821345844
MN
01
H401132214
MEDICARE
MN
Enumeration date
08/08/2012
Last updated
08/23/2024
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