Provider Demographics
NPI:1629309570
Name:STORMER-WASHINGTON, GLORIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:
Last Name:STORMER-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 1:1586 FORESTBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-7610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1586 FORESTBROOK LN
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-7610
Practice Address - Country:US
Practice Address - Phone:216-534-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN319042163WC1500X, 163WD0400X, 163WG0600X, 163WH0200X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis