Provider Demographics
NPI:1740513316
Name:WASHINGTON, CARMEN ROZELLE (EDD, FNP)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ROZELLE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:EDD, FNP
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:ROZELLE
Other - Last Name:WASHINGTON, EDD, FNP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR CARMEN WASHINGTON
Mailing Address - Street 1:2730 W AGUA FRIA FWY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-7201
Mailing Address - Country:US
Mailing Address - Phone:623-434-6698
Mailing Address - Fax:623-434-6694
Practice Address - Street 1:2730 W AGUA FRIA FWY STE 104
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-7202
Practice Address - Country:US
Practice Address - Phone:623-434-6698
Practice Address - Fax:623-434-6694
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3327207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP3327OtherAP LICENSE NUMBER