Provider Demographics
NPI:1144466673
Name:WASHINGTON, TANOVIA L
Entity type:Individual
Prefix:MS
First Name:TANOVIA
Middle Name:L
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-6013
Mailing Address - Country:US
Mailing Address - Phone:772-882-9450
Mailing Address - Fax:717-924-5632
Practice Address - Street 1:904 N 21ST ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-6013
Practice Address - Country:US
Practice Address - Phone:772-882-9450
Practice Address - Fax:717-924-5632
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker