Provider Demographics
NPI:1932409299
Name:WASHINGTON, LISA ANJANETTE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANJANETTE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:20126 STILL WIND DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3548
Mailing Address - Country:US
Mailing Address - Phone:813-383-3073
Mailing Address - Fax:813-745-5441
Practice Address - Street 1:605 MEDICAL CARE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5942
Practice Address - Country:US
Practice Address - Phone:813-681-6474
Practice Address - Fax:813-654-8473
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL3354502363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health