Provider Demographics
NPI:1992463293
Name:WASHINGTON, KAREN LATRICE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LATRICE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44482-0544
Mailing Address - Country:US
Mailing Address - Phone:330-979-2455
Mailing Address - Fax:
Practice Address - Street 1:2500 TOD AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-1922
Practice Address - Country:US
Practice Address - Phone:330-979-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0029745363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0029745OtherOHIO BOARD OF NURSING