Provider Demographics
NPI:1205441615
Name:WASHINGTON HILLS PRIMARY CARE LLC
Entity type:Organization
Organization Name:WASHINGTON HILLS PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTONOMOUS NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:I
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, GNP-BC
Authorized Official - Phone:904-406-9399
Mailing Address - Street 1:1532 KINGSLEY AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4526
Mailing Address - Country:US
Mailing Address - Phone:904-406-9399
Mailing Address - Fax:833-673-0308
Practice Address - Street 1:1532 KINGSLEY AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4526
Practice Address - Country:US
Practice Address - Phone:904-406-9399
Practice Address - Fax:833-673-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care