Provider Demographics
NPI:1255005716
Name:WILLIAMS, VERNICE HELENA
Entity Type:Individual
Prefix:
First Name:VERNICE
Middle Name:HELENA
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 1:404A HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2650
Mailing Address - Country:US
Mailing Address - Phone:718-576-9336
Mailing Address - Fax:718-234-7096
Practice Address - Street 1:241 37TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2417
Practice Address - Country:US
Practice Address - Phone:718-232-1500
Practice Address - Fax:718-234-7096
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY609165163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse