Provider Demographics
NPI:1275830176
Name:WASHINGTON, KATINA LYNNETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATINA
Middle Name:LYNNETTE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 TERRACE VW N
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-1051
Mailing Address - Country:US
Mailing Address - Phone:419-508-1909
Mailing Address - Fax:
Practice Address - Street 1:4415 TERRACE VW N
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-1051
Practice Address - Country:US
Practice Address - Phone:419-508-1909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN331092163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse