Stacy Washington, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

222305 Issued in NC

Practice address

3073 Boone Trail Ext
Fayetteville, NC 28304-3805

Phone

(910) 429-2263

NPI assigned

Aug 18, 2014

Last updated

May 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Xubian Wellness & Acne Clinic, P.C.

  • Clinic/Center
  • Fayetteville, NC
  • NPI 1689073447
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1598164345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 EAGLE CREST LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283068093",
            "telephone_number": "910-574-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 BOONE TRAIL EXT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043805",
            "telephone_number": "910-429-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "STACY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "NC",
            "license": "11794",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NC",
            "license": "222305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hydeia Washington
• Latisha Alexandria Renee Washington
• Lyric Washington
• Mariya Washington
• Neola Washington
• Tashayla Washington, LCAS-A, LCSW-A
• Thomas Washington II, LCSWA
• Tonya Lakeshia Washington, CSFA
• Tara Stallings Waters
• Katrina Ann Watford Gamble, MA,NCC,LPC

• General Practice Registered Nurse in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• General Practice Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.