Provider Demographics
NPI:1245590660
Name:WILLIAMS, NAOMI QAADIRA (CNA)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:QAADIRA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 LAKE VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4258
Mailing Address - Country:US
Mailing Address - Phone:240-423-0794
Mailing Address - Fax:
Practice Address - Street 1:11100 LAKE VICTORIA LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4258
Practice Address - Country:US
Practice Address - Phone:240-423-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00095502376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide