Provider Demographics
NPI:1336639152
Name:WILLIAMS, KAMEKA GENELL (LVN)
Entity Type:Individual
Prefix:MRS
First Name:KAMEKA
Middle Name:GENELL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 WINEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1682
Mailing Address - Country:US
Mailing Address - Phone:832-746-7295
Mailing Address - Fax:713-491-6422
Practice Address - Street 1:12401 WINEBROOK DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1682
Practice Address - Country:US
Practice Address - Phone:832-746-7295
Practice Address - Fax:713-491-6422
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX183923164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183923OtherBVNE