Healthcare Provider Details

I. General information

NPI: 1659881431
Provider Name (Legal Business Name): DENNISE WASHINGTON CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WELLNESS WAY
MILFORD DE
19963-4364
US

IV. Provider business mailing address

640 S. STATE STREET MAIL CODE 3076
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-430-5145
  • Fax: 302-430-5369
Mailing address:
  • Phone: 302-744-6180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberLN-0000131
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberLN-0000131
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: