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Individual

MISTY WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1041 E SULLIVAN ST, KINGSPORT, TN 37660-5242
(423) 279-2777
Mailing address
1041 E SULLIVAN ST, KINGSPORT, TN 37660-5242
(423) 279-2777

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00162224
TN

Other

Enumeration date
11/17/2014
Last updated
11/17/2014
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