Provider Demographics
NPI:1376314559
Name:WILLIAMS, ELISHA LAFAYE
Entity Type:Individual
Prefix:MISS
First Name:ELISHA
Middle Name:LAFAYE
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 1:3525 SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8002
Mailing Address - Country:US
Mailing Address - Phone:678-458-2757
Mailing Address - Fax:
Practice Address - Street 1:3525 SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-8002
Practice Address - Country:US
Practice Address - Phone:678-458-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport