Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125053328 | IL |
N | 208000000X | Pediatrician | A113090 | CA |
Y | 2080P0216X | Pediatric Rheumatologist | MD2021-0243 | NM |
NPI | 1679740906 |
---|---|
Provider Name | Dr. Nina T Washington |
First Address | Madison, MS 39110-6115 |
Second Address | Madison, MS 39110-2012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01080372 | (05) | MS |