1225247257 NPI number — MS. KIMBERLEY D WILLIAMS NURSE PRACTITIONER

Table of content: MS. KIMBERLEY D WILLIAMS NURSE PRACTITIONER (NPI 1225247257)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225247257 NPI number — MS. KIMBERLEY D WILLIAMS NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
KIMBERLEY
Provider Middle Name:
D
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225247257
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1213 E CLAY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23298-5071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-828-9956
Provider Business Mailing Address Fax Number:
804-828-6662

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1213 E CLAY ST
Provider Second Line Business Practice Location Address:
BOX 985912
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23298-5071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-828-9956
Provider Business Practice Location Address Fax Number:
804-828-6662
Provider Enumeration Date:
05/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LN0005X , with the licence number:  0024164533 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com