Individual
LISA KATHERYN WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
36613
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1291T
BCBS
—
05
—
2006796000
—
WV
01
—
43973
PARTNERS
—
05
—
6739041
—
VA
01
—
7576302
AETNA
—
05
—
891291T
—
NC
01
—
B1069
MEDCOST
—
Enumeration date
12/02/2005
Last updated
12/09/2008
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