Provider Demographics
NPI:1053442442
Name:WILLIAMS, VERA LOUISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:VERA
Middle Name:LOUISE
Last Name:WILLIAMS
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 1:618 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5032
Mailing Address - Country:US
Mailing Address - Phone:317-637-3449
Mailing Address - Fax:317-637-3440
Practice Address - Street 1:501 N EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1632
Practice Address - Country:US
Practice Address - Phone:317-924-6351
Practice Address - Fax:317-927-3098
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28114105A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28114105AOtherREGISTERED NURSE LICENSE