Basic Information
| Provider Information | |||||||||
| NPI: | 1780207258 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WASHINGTON | ||||||||
| FirstName: | JASMINE | ||||||||
| MiddleName: | CALVINA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSN, APRN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1068 FRIARTUCK TRL | ||||||||
| Address2: | |||||||||
| City: | LADSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294563065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434693732 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 370 S PIKE W | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291502664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037747337 | ||||||||
| FaxNumber: | 8037744629 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2020 | ||||||||
| LastUpdateDate: | 05/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 23771 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.