Provider Demographics
NPI:1003500554
Name:WHITE, JASMINE LANA'E
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:LANA'E
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 STEIN CT APT 104
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-1757
Mailing Address - Country:US
Mailing Address - Phone:330-554-1775
Mailing Address - Fax:
Practice Address - Street 1:926 STEIN CT APT 104
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-1757
Practice Address - Country:US
Practice Address - Phone:330-554-1775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker