Most Relevant Information
Provider Data
| NPI Number: | 1003432568 |
| Provider Name: | JACQUELINE ELAINE WHITE CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 1-119185 |
Most Important Dates
| Enumeration Date: | 06/22/2020 |
| Last Updated: | 06/22/2020 |
Provider Practice Location
3105 31ST AVE
NORTHPORT
AL
354765240
Practice Location Phone/Fax
| Phone: | 2052927230 |
| Fax: |
Provider Mailing Location
3105 31ST AVE
NORTHPORT
AL
354765240
Provider Mailing Phone/Fax
| Phone: | 2052927230 |
| Fax: |