Provider Demographics
NPI:1386250348
Name:JESSICA M WHITE, ARNP, INC
Entity type:Organization
Organization Name:JESSICA M WHITE, ARNP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:818-263-4362
Mailing Address - Street 1:2607 BRIDGEPORT WAY W STE 2E
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4725
Mailing Address - Country:US
Mailing Address - Phone:818-263-4362
Mailing Address - Fax:206-567-1928
Practice Address - Street 1:2607 BRIDGEPORT WAY W STE 2E
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4725
Practice Address - Country:US
Practice Address - Phone:818-263-4362
Practice Address - Fax:206-567-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty