Jeniffer Ane Washington

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

1798656 Issued in MO

Practice address

3430 McKelvey Rd
Bridgeton, MO 63044-2579

Phone

(314) 629-2018

NPI assigned

Jul 28, 2023

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1861173205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 MCKELVEY RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442579",
            "telephone_number": "314-629-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 MCKELVEY RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442579",
            "telephone_number": "314-629-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "JENIFFER",
        "middle_name": "ANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "1798656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Walters, MOT, OTR/L
• Kongkeo Thiky Walther, ANP
• William Wang, M.D.
• Victoria Wannemuehler, MS, RDN, LD
• Waqar Ulislam Mirza MD
• Keisha L Waters
• Alecia Watts, MSW, LMSW
• L Marilyn Weaks, DMD
• Robin Anne Weaver, M.P.T.
• Phillip Michael Webber, PHARMD

• Licensed Practical Nurse in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.