Provider Demographics
NPI:1942786629
Name:WASHINGTON, BREA ANJANEE' (NP-BC)
Entity type:Individual
Prefix:MRS
First Name:BREA
Middle Name:ANJANEE'
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 MCCULLOUGH DRIVE
Mailing Address - Street 2:SUITE 400- #9522
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:980-277-4475
Mailing Address - Fax:980-243-7555
Practice Address - Street 1:301 MCCULLOUGH DRIVE
Practice Address - Street 2:SUITE 400- #9522
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:980-277-4475
Practice Address - Fax:980-243-7555
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5010699363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner