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General NPI Number Information
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NPI Number | 1679740906
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Entity Type | Individual
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Provider Name | NINA T WASHINGTON MD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 401 BAPTIST DR STE 301
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City | MADISON
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State | MS
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Zip | 39110-2012
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Country | US
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Telephone | 601-499-0935
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Fax | 601-499-0936
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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Fax | 601-499-0936
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A113090
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | MD2021-0243
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 125053328
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License Number State | IL
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