Provider Demographics
NPI:1083877302
Name:INJECTABLE CONSULTANTS, LLC.
Entity Type:Organization
Organization Name:INJECTABLE CONSULTANTS, LLC.
Other - Org Name:LISA M. WILLIAMS ARNP, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:502-744-9950
Mailing Address - Street 1:PO BOX 5794
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40255-0794
Mailing Address - Country:US
Mailing Address - Phone:502-744-9950
Mailing Address - Fax:
Practice Address - Street 1:1911 TREVILIAN WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2139
Practice Address - Country:US
Practice Address - Phone:502-744-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4753P314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility