1245325711 NPI number — MRS. KATHY YVONNE WILLIAMS CPM-TN

Table of content: MRS. KATHY YVONNE WILLIAMS CPM-TN (NPI 1245325711)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245325711 NPI number — MRS. KATHY YVONNE WILLIAMS CPM-TN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
KATHY
Provider Middle Name:
YVONNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CPM-TN
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:
1245325711
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6010 LAKEVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37172-6620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-838-8300
Provider Business Mailing Address Fax Number:
615-384-1457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6010 LAKEVIEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37172-6620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-838-8300
Provider Business Practice Location Address Fax Number:
615-384-1457
Provider Enumeration Date:
10/03/2006

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: 146N00000X , with the licence number:  EMT000031310 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: CPM000000020 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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