Shantale Washington, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F07240070 Issued in NC

Practice address

10175 Little Patuxent Pkwy
Columbia, MD 21044-2655

Phone

(855) 247-8474

NPI assigned

Jul 2, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1841036761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 CROW POINT WAY",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097063",
            "telephone_number": "757-402-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655",
            "telephone_number": "855-247-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "SHANTALE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "F07240070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan M Warthen
• Cierra J Washington, RMP
• Daphne Lavone Blick Washington, PH.D.,LCPC,NCC,DCC
• Jennifer Washington
• Makiyah Washington
• Stacy Washington
• Steven Washington
• Jennifer Wasmus
• Janis K Wasser, M.A., MBA
• Marlena P Waters Bordley

• Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.