Provider Demographics
NPI:1376760322
Name:WILLIAMS, JULIET ANGELA (RN, BSN, CNOR, RNFA)
Entity Type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:ANGELA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, BSN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26354 OAK LEAF LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:IL
Mailing Address - Zip Code:61520-9347
Mailing Address - Country:US
Mailing Address - Phone:309-649-9136
Mailing Address - Fax:309-649-9136
Practice Address - Street 1:26354 OAK LEAF LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-9347
Practice Address - Country:US
Practice Address - Phone:309-649-9136
Practice Address - Fax:309-649-9136
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant