Provider Demographics
NPI:1144788134
Name:WHITE NEGRON, VERONICA A (BSN)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:A
Last Name:WHITE NEGRON
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 N ELLISTON TROWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:OH
Mailing Address - Zip Code:43445-9727
Mailing Address - Country:US
Mailing Address - Phone:419-466-3794
Mailing Address - Fax:
Practice Address - Street 1:6120 N ELLISTON TROWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:OH
Practice Address - Zip Code:43445-9727
Practice Address - Country:US
Practice Address - Phone:419-466-3794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH294600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse