Provider Demographics
NPI:1639691447
Name:WASHINGTON, TENICIA S (CRNP)
Entity Type:Individual
Prefix:MS
First Name:TENICIA
Middle Name:S
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 N POINT BLVD STE 321
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3472
Mailing Address - Country:US
Mailing Address - Phone:410-517-7060
Mailing Address - Fax:443-407-2942
Practice Address - Street 1:1105 N POINT BLVD STE 321
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3472
Practice Address - Country:US
Practice Address - Phone:410-517-7060
Practice Address - Fax:443-407-2942
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197069363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health