Provider Demographics
NPI:1467863613
Name:WILLIAMS, JANELL CHUNN
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:CHUNN
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 1:120 MONTGOMERY RD
Mailing Address - Street 2:PO BOX 1534
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-6258
Mailing Address - Country:US
Mailing Address - Phone:931-842-0119
Mailing Address - Fax:
Practice Address - Street 1:120 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-6258
Practice Address - Country:US
Practice Address - Phone:931-842-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000018465363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily