1497958854 NPI number — MS. PAIGE ALAINE WILLIAMS PA

Table of content: MS. PAIGE ALAINE WILLIAMS PA (NPI 1497958854)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497958854 NPI number — MS. PAIGE ALAINE WILLIAMS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
PAIGE
Provider Middle Name:
ALAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEAN
Provider Other First Name:
PAIGE
Provider Other Middle Name:
ALAINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497958854
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7710 MERCY RD
Provider Second Line Business Mailing Address:
SUITE 406
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68124-2346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-717-2500
Provider Business Mailing Address Fax Number:
402-717-2525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7710 MERCY RD
Provider Second Line Business Practice Location Address:
SUITE 406
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68124-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-717-2500
Provider Business Practice Location Address Fax Number:
402-717-2525
Provider Enumeration Date:
06/05/2007

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: 363A00000X , with the licence number:  1323 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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