Individual
EBONY J WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11445 REIGER RD, BATON ROUGE, LA 70809-4556
(225) 877-3499
Mailing address
21036 N HIGH PLAINS DR, ZACHARY, LA 70791-5497
(225) 802-1500
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
260136
LA
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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