| NPI | 1336548155 |
|---|---|
| Former Name | JENNIFER NICOLE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209017894) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 041.416814) |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| 363L00000X Nurse Practitioner (Licence: MO 2020041195) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017894) | |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2021-01-11 |