Provider Demographics
NPI:1245590462
Name:WILLIAMS, ASHLEY LATOYA (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LATOYA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 MOUNT HOPE AVE
Mailing Address - Street 2:APT. 3
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2230
Mailing Address - Country:US
Mailing Address - Phone:585-355-7431
Mailing Address - Fax:
Practice Address - Street 1:466 MOUNT HOPE AVE
Practice Address - Street 2:APT. 3
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2230
Practice Address - Country:US
Practice Address - Phone:585-355-7431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300329164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse