Provider Demographics
NPI:1306263389
Name:WASHINGTON, PAULINA (NP)
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E WAYNE ST STE 175
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-2716
Mailing Address - Country:US
Mailing Address - Phone:260-420-2800
Mailing Address - Fax:888-251-0972
Practice Address - Street 1:327 E WAYNE ST STE 175
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-2716
Practice Address - Country:US
Practice Address - Phone:260-420-2800
Practice Address - Fax:888-251-0972
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007498A363L00000X
KS28204625A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse