Provider Demographics
NPI:1710008776
Name:NORMAND WHITE, JEANNE MARIE (LAC)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:NORMAND WHITE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:MARIE
Other - Last Name:NORMAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:850 SISKIYOU BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2125
Mailing Address - Country:US
Mailing Address - Phone:541-482-7056
Mailing Address - Fax:541-482-7058
Practice Address - Street 1:850 SISKIYOU BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2125
Practice Address - Country:US
Practice Address - Phone:541-482-7056
Practice Address - Fax:541-482-7058
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00789171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist