Healthcare Provider Details

I. General information

NPI: 1023827664
Provider Name (Legal Business Name): WILIMINNE ELIZABETH WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 CROSSWINDS DR APT 303
CHESAPEAKE VA
23320-5156
US

IV. Provider business mailing address

224 CROSSWINDS DR APT 303
CHESAPEAKE VA
23320-5156
US

V. Phone/Fax

Practice location:
  • Phone: 917-628-7885
  • Fax:
Mailing address:
  • Phone: 917-628-7885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0042520
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: