MEDICARE: DR. TONITA R WASHINGTON FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9390205	FL
2	363LF0000X	Family Nurse Practitioner	RN198365	GA

General Provider Information

NPI Number	:	1306162797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONITA R WASHINGTON FNP-BC

Provider Business Mailing Address
First Line	:	1846 OLD NORCROSS RD STE 100
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-8801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1846 OLD NORCROSS RD STE 100
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-8801
Country	:	US
Telephone Number	:	678-729-7453
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2010
Last Update Date	:	03/17/2018

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