Provider Demographics
NPI:1336762178
Name:ABBOT-WHITE, LOIS A (RN)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:A
Last Name:ABBOT-WHITE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:A
Other - Last Name:PIERCE, HUFF, BARRIE, STADELMAN, AB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:114 W HOLLISTER ST
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-4756
Mailing Address - Country:US
Mailing Address - Phone:248-977-8201
Mailing Address - Fax:586-785-3078
Practice Address - Street 1:114 W HOLLISTER ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-4756
Practice Address - Country:US
Practice Address - Phone:248-977-8201
Practice Address - Fax:586-785-3078
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704185259163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse