Provider Demographics
NPI:1376843862
Name:WILLIAMS, EBUN VICTORIA (RN)
Entity Type:Individual
Prefix:MS
First Name:EBUN
Middle Name:VICTORIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6937 LAMONT DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4606
Mailing Address - Country:US
Mailing Address - Phone:240-468-6077
Mailing Address - Fax:877-565-7126
Practice Address - Street 1:6937 LAMONT DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4606
Practice Address - Country:US
Practice Address - Phone:240-468-6077
Practice Address - Fax:866-565-7126
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-30
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN968393163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health