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General NPI Number Information
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NPI Number | 1205441615
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Entity Type | Organization
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Legal Business Name | WASHINGTON HILLS PRIMARY CARE LLC
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 1532 KINGSLEY AVE STE 101
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City | ORANGE PARK
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State | FL
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Zip | 32073-4526
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Country | US
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Telephone | 904-406-9399
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Fax | 833-673-0308
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Provider Business Mailing Address
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Address Line | 1532 KINGSLEY AVE STE 101
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City | ORANGE PARK
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State | FL
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Zip | 32073-4526
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Country | US
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Telephone | 904-406-9399
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Fax | 833-673-0308
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Authorized Official
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Title or Position | AUTONOMOUS NURSE PRACTITIONER
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Name | REGINA I WASHINGTON
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Credential | APRN, GNP-BC
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Telephone | 904-406-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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