Provider Demographics
NPI:1144633116
Name:WASHINGTON, KNYESHA (LPN)
Entity type:Individual
Prefix:
First Name:KNYESHA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10626 DURREY CT
Mailing Address - Street 2:
Mailing Address - City:REMINDERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8192
Mailing Address - Country:US
Mailing Address - Phone:216-403-7842
Mailing Address - Fax:
Practice Address - Street 1:10626 DURREY CT
Practice Address - Street 2:
Practice Address - City:REMINDERVILLE
Practice Address - State:OH
Practice Address - Zip Code:44202-8192
Practice Address - Country:US
Practice Address - Phone:216-403-7842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-08
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 149326164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse