Provider Demographics
NPI:1275729147
Name:WILLIAMS, ASSIA NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:ASSIA
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MCINTOSH RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3035
Mailing Address - Country:US
Mailing Address - Phone:856-582-4195
Mailing Address - Fax:
Practice Address - Street 1:941 DURHAM RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-5738
Practice Address - Country:US
Practice Address - Phone:215-750-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN550437163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency