| NPI | 1679039606 |
|---|---|
| Former Name | JACQUELINE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 203678) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 203678) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 203678) | |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2025-12-17 |