Individual
MRS. LATISHA SHIROSE WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6202 DUPREE AVE, FERGUSON, MO 63135-3219
(314) 440-7928
Mailing address
6202 DUPREE AVE, FERGUSON, MO 63135-3219
(314) 440-7928
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
2002003900
MO
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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