Provider Demographics
NPI:1134409642
Name:WHITE, JANEE L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JANEE
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13125 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-2759
Mailing Address - Country:US
Mailing Address - Phone:904-596-1653
Mailing Address - Fax:904-714-6371
Practice Address - Street 1:13125 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-2759
Practice Address - Country:US
Practice Address - Phone:904-596-1653
Practice Address - Fax:904-714-6371
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42935183500000X
GARPH024649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist