Provider Demographics
NPI:1245606482
Name:WILLIAMS, JANET LEE (LPN ID#4703087239)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN ID#4703087239
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:RETHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:118 TAFT ST.
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014
Mailing Address - Country:US
Mailing Address - Phone:269-578-6235
Mailing Address - Fax:
Practice Address - Street 1:118 TAFT ST.
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014
Practice Address - Country:US
Practice Address - Phone:269-578-6235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703087239164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse