Provider Demographics
NPI:1194022905
Name:WASHINGTON, LASHANDA RENEE (LICENSE NURSE)
Entity Type:Individual
Prefix:MS
First Name:LASHANDA
Middle Name:RENEE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LICENSE NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5950 CULZEAN DR APT 1408
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1245
Mailing Address - Country:US
Mailing Address - Phone:414-292-7873
Mailing Address - Fax:
Practice Address - Street 1:5950 CULZEAN DR APT 1408
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-1245
Practice Address - Country:US
Practice Address - Phone:414-292-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH117707374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician