Provider Demographics
NPI:1730749474
Name:WASHINGTON, KEMOSHA DENISE (CNA)
Entity type:Individual
Prefix:
First Name:KEMOSHA
Middle Name:DENISE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 SIERRA BLANCA DR APT 4407
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-7505
Mailing Address - Country:US
Mailing Address - Phone:832-258-5380
Mailing Address - Fax:
Practice Address - Street 1:6301 SIERRA BLANCA DR APT 4407
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-7505
Practice Address - Country:US
Practice Address - Phone:832-258-5380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health