Provider Demographics
NPI:1851536015
Name:WHITE, JENNIFER LEIGH (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
Last Name:WHITE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LEIG
Other - Last Name:DAMEWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1718 SAINT MARY ST STE A
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4518
Mailing Address - Country:US
Mailing Address - Phone:865-540-4288
Mailing Address - Fax:865-637-6983
Practice Address - Street 1:1718 SAINT MARY ST STE A
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4518
Practice Address - Country:US
Practice Address - Phone:865-540-4288
Practice Address - Fax:865-637-6983
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013667208000000X
TN13667363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics