Jacie B White, LVN

Individual provider Active NPI Licensed Vocational Nurse · Teague, TX

NPI 1144716366 · NPPES record last updated Jul 11, 2018

Key facts

NPI
1144716366
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
341805 (TX)
Practice address
702 S 10TH Ave
Teague, TX 75860-2308
Phone
(254) 747-0010
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
341805TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 341805 TX Yes

Addresses

Primary practice location

702 S 10TH Ave
Teague, TX 75860-2308

Mailing address

4030 Highway 6 S Ste 150
College Station, TX 77845-1808

Other providers in Teague, TX

All providers in Teague, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.