Provider Demographics
NPI:1225892110
Name:WASHINGTON, VENIECEIA LYNETTE JR
Entity Type:Individual
Prefix:MS
First Name:VENIECEIA
Middle Name:LYNETTE
Last Name:WASHINGTON
Suffix:JR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 GORETTI DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:OH
Mailing Address - Zip Code:44405-1905
Mailing Address - Country:US
Mailing Address - Phone:330-556-2042
Mailing Address - Fax:
Practice Address - Street 1:93 GORETTI DR
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:OH
Practice Address - Zip Code:44405-1905
Practice Address - Country:US
Practice Address - Phone:330-506-7577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide