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General NPI Number Information
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NPI Number | 1548643307
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Entity Type | Individual
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Provider Name | GARY NATHAN WASHINGTON FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 12 7TH ST
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City | AUBURN
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State | GA
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Zip | 30011-3202
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Country | US
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Telephone | 770-848-9320
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Fax |
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Provider Business Mailing Address
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Address Line | 550 ROCK SPRINGS PL NE APT 113
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City | ATLANTA
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State | GA
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Zip | 30306-2383
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Country | US
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Telephone | 678-446-1308
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN204167
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R215808
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License Number State | MD
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