White, Jimmy A

White, Jimmy A is an individual health care provider with primary practice located at 3217 Mabel St , Shreveport LA 71103-4022. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. White, Jimmy A can be contacted via phone (318) 631-9121.

Contact Information

Primary practice address
3217 Mabel St Shreveport LA 71103-4022
Phone: (318) 631-9121
Fax: (318) 631-9126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APO4661 Louisiana

Profile Details

NPI number 1548212889
LBN Legal business name White, Jimmy A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Mar 29th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548212889 NPPES
Louisiana MEDICAID 1624250

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