Provider Demographics
NPI:1114391018
Name:WILLIAMS, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8081 ARCO CORPORATE DR STE 130
Mailing Address - Street 2:VA DIALYSIS CLINIC AT BRIER CREEK
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-2042
Mailing Address - Country:US
Mailing Address - Phone:919-286-5220
Mailing Address - Fax:919-285-5221
Practice Address - Street 1:8081 ARCO CORPORATE DR STE 130
Practice Address - Street 2:VA DIALYSIS CLINIC AT BRIER CREEK
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-2042
Practice Address - Country:US
Practice Address - Phone:919-286-5220
Practice Address - Fax:919-285-5221
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000025133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal