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General NPI Number Information
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NPI Number | 1053620971
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Entity Type | Individual
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Provider Name | CAROL LISHA WHITTINGTON-WASHINGTON CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 6490 LANDOVER RD SUITE H
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City | CHEVERLY
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State | MD
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Zip | 20785-1443
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Country | US
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Telephone | 301-322-1696
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Fax | 301-322-9122
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Provider Business Mailing Address
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Address Line | 6490 LANDOVER RD SUITE H
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City | CHEVERLY
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State | MD
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Zip | 20785-1443
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Country | US
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Telephone | 301-322-1696
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Fax | 301-322-9122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R094051
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License Number State | MD
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