Individual
CLARA LEE RENIA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N. B.S.N.
Contact information
Practice address
8900 SHILOH DR, MABELVALE, AR 72103-2141
(501) 240-8771
Mailing address
6475 PIERCE MANSE LOOP, BENTON, AR 72019-8541
(501) 240-8771
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R42861
AR
163WC0400X
Case Management Registered Nurse
Primary
R42861
AR
163WC1400X
College Health Registered Nurse
R42861
AR
163WC1500X
Community Health Registered Nurse
R42861
AR
163WC1600X
Continuing Education/Staff Development Registered Nurse
R42861
AR
163WH0200X
Home Health Registered Nurse
R42861
AR
Other
Enumeration date
12/21/2020
Last updated
09/22/2021
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