Jenna White
Nurse Practitioner, Family in Rocky Ford, CO. Individual provider (NPI-1).
NPI number1124445895
StatusActive
Last updated in NPPESOct 13, 2020
Details
- NPI
- 1124445895
- Entity type
- Individual (NPI-1)
- Name
- Jenna White
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 19, 2014
- Certification date
- Oct 13, 2020
- Last updated
- Oct 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 0991101 | CO | Yes |
Practice location
26433 Cr GgRocky Ford, CO 81067-8106
Phone 719-999-9999
Mailing address
1120 E 3rd StLa Junta, CO 81050-1906
Phone 719-363-1514 · Fax 719-468-2427
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