Provider Demographics
NPI:1003134768
Name:WILLIAMS LUKE, GILLIAN M (RN)
Entity Type:Individual
Prefix:MRS
First Name:GILLIAN
Middle Name:M
Last Name:WILLIAMS LUKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9475 LOTTSFORD RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5357
Mailing Address - Country:US
Mailing Address - Phone:301-636-6504
Mailing Address - Fax:301-636-6509
Practice Address - Street 1:9475 LOTTSFORD RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5357
Practice Address - Country:US
Practice Address - Phone:301-636-6504
Practice Address - Fax:301-636-6509
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD185721163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse