Provider Demographics
NPI:1225453350
Name:WILLIAMS, HARRY
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 S SANDHILL RD APT 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-1727
Mailing Address - Country:US
Mailing Address - Phone:702-416-8981
Mailing Address - Fax:
Practice Address - Street 1:2861 S SANDHILL RD APT 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-1727
Practice Address - Country:US
Practice Address - Phone:702-416-8981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide