Provider Demographics
NPI:1215611496
Name:WASHINGTON, SYDNEY NICOLE
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:NICOLE
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 1:37408 COAL RIVER RD APT 105
Mailing Address - Street 2:
Mailing Address - City:WHITESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25209-9000
Mailing Address - Country:US
Mailing Address - Phone:304-854-2108
Mailing Address - Fax:
Practice Address - Street 1:37408 COAL RIVER RD APT 105
Practice Address - Street 2:
Practice Address - City:WHITESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25209-9000
Practice Address - Country:US
Practice Address - Phone:304-854-2108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant