Provider Demographics
NPI:1043079767
Name:WASHINGTON, CARMEN HENRINNE SR (CNA)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:HENRINNE
Last Name:WASHINGTON
Suffix:SR
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-3520
Mailing Address - Country:US
Mailing Address - Phone:386-601-1303
Mailing Address - Fax:386-601-1303
Practice Address - Street 1:246 GARDEN ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3520
Practice Address - Country:US
Practice Address - Phone:386-601-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133242251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care