=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306024807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER E WASHINGTON RN-CRNFA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2008
-----------------------------------------------------
Last Update Date | 02/06/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 236 W RIDGEWOOD AVE
-----------------------------------------------------
City | PLEASANTVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08232-3740
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-646-2362
-----------------------------------------------------
Fax | 609-646-1241
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 494
-----------------------------------------------------
City | NORTHFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08225-0494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-646-2362
-----------------------------------------------------
Fax | 609-646-1241
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WR0006X
-----------------------------------------------------
Taxonomy Name | Registered Nurse First Assistant
-----------------------------------------------------
License Number | 26N005587800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------