MRS. BRUCHELL DENISE WASHINGTON (NPI# 1346552783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346552783 |
| Entity Type | Individual |
| Full Name | MRS. BRUCHELL DENISE WASHINGTON |
| Practice Address |
4224 Wilshire Dr Valdosta GA 31605-7020 |
| Practice Telephone | 2292574317 |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
4224 WILSHIRE DR |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31605-7020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484718 | Mckenna Kristine Bachmann | Specialist/Technologist | Moody Air Force Base, Valdosta, GA 31605 | 2020-07-14 |
| 1376056366 | Michael Brent Robinson Sr. | Contractor | 3863 Camellia Dr., Valdosta, GA 31605 | 2017-11-13 |
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1649683541 | Dustin Ross Kilby | Dentist | 2704 Oak Center Dr, Valdosta, GA 31605 | 2014-06-09 |
| 1659643286 | Brittnaey Nicole Freeman | Behavioral Analyst | 3982 Karaline Cir, Valdosta, GA 31605 | 2012-01-27 |
| 1780970335 | Laura Christen Cribbs | Counselor | 3312-d N Oak Street Ext, Valdosta, GA 31605 | 2011-06-22 |
| 1992090633 | Mary Katelyn Harper | Pharmacist | 3200 North Oak Street, Valdosta, GA 31605 | 2011-06-10 |
| 1053532937 | Robert Mark Pearson | Dentist | 3227 N. Oak St. Ext., Valdosta, GA 31605 | 2007-05-01 |
| 1083838650 | Am Sleep Diagnostics and Research Center | Clinic/Center | 3334 Greyatone Way, Valdosta, GA 31605 | 2007-04-12 |
| 1831236181 | William Ashley Moorman | Dentist | Advanced Dental Care, 3211 Wildwood Plantation Drive, Valdosta, GA 31605 | 2007-01-30 |
| Find all providers in zip 31605 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952701641 | Alan Vega | Military Health Care Provider | 3715 N Valdosta Rd Apt 82, Valdosta, GA 31602 | 2014-08-29 |
| 1205110368 | Brian Russell Balcolm | Military Health Care Provider | 4099 Forrest Run Cir, Valdosta, GA 31605-6538 | 2011-10-06 |
| 1689957862 | Monique Nicole Toth | Military Health Care Provider | 3748 Robin Ln, Valdosta, GA 31605-5102 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003459942 | Summer Ann Felix | Military Health Care Provider | 4260 Nelson Hill Pl, Hahira, GA 31632-3264 | 2019-10-23 |
| 1811397243 | Kristy Luna | Military Health Care Provider | 2331 Downing Ave, Savannah, GA 31404-3953 | 2014-09-04 |
| 1548697485 | John Dye Jr. | Military Health Care Provider | 655 Seventh St., Robins Afb, GA 31098 | 2013-10-10 |
| 1306189576 | Rebecca Lynne Lozano | Military Health Care Provider | 620 Randolph Ave, Warner Robins, GA 31098-1162 | 2013-04-05 |
| 1316230527 | Tamara Alisha Ivy | Military Health Care Provider | 138 Washington Ave, Waynesboro, GA 30830-8421 | 2011-05-20 |
| 1114221439 | Stephanie Denise Sulewski | Military Health Care Provider | 1063 Uss Tennessee Ave, Avenue Ql 11, Kings Bay, GA 31547-2606 | 2010-12-29 |
| 1194033365 | Jessica Marie Barker | Military Health Care Provider | 317 Simms Rd, Carrollton, GA 30117-5611 | 2010-09-21 |
| 1639480809 | Christina Marie Barta | Military Health Care Provider | 79 Live Oak Trl, Lakeland, GA 31635-5813 | 2010-06-23 |
| 1881905073 | Chun Chung Fong | Military Health Care Provider | 3278 Mitchell Blvd Bldg 900, Moody Afb, GA 31699-1500 | 2010-06-23 |
| 1811128754 | Shawn Christopher Moore | Military Health Care Provider | 655th 7th Street, Robins Afb, GA 31098 | 2009-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.