Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 112811 | NE |
NPI | 1093374332 |
---|---|
Provider Name | Allison White |
First Address | Lincoln, NE 68516-1669 |
Second Address | Lincoln, NE 68510-4970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2019 |
Last Update Date | 11/06/2019 |