=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518395268
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEKEYTRA WASHINGTON NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2013
-----------------------------------------------------
Last Update Date | 01/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6350 DAVIS BLVD # 200
-----------------------------------------------------
City | NORTH RICHLAND HILLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76180-4762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-525-9900
-----------------------------------------------------
Fax | 469-333-7988
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 360541 SUITE 2500
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15251-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-525-9900
-----------------------------------------------------
Fax | 469-333-7988
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP07571
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------