Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | H156070 | IA |
N | 363LA2100X | Nurse Practitioner - Acute Care | H156070 | IA |
N | 363LA2200X | Nurse Practitioner - Adult Health | H156070 | IA |
N | 363LG0600X | Nurse Practitioner - Gerontology | H156070 | IA |
NPI | 1033771258 |
---|---|
Provider Name | Ms. Tyeisha Marie Washington |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2019 |
Last Update Date | 06/11/2019 |