Provider Demographics
NPI:1932827755
Name:WASHINGTON, DARNICKA NICOLE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DARNICKA
Middle Name:NICOLE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 FISHER CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8762
Mailing Address - Country:US
Mailing Address - Phone:615-617-2456
Mailing Address - Fax:
Practice Address - Street 1:905 FISHER CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-8762
Practice Address - Country:US
Practice Address - Phone:615-617-2456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN247318163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty