Provider Demographics
NPI:1497958854
Name:WILLIAMS, PAIGE ALAINE (PA)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:ALAINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:PAIGE
Other - Middle Name:ALAINE
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7710 MERCY RD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2346
Mailing Address - Country:US
Mailing Address - Phone:402-717-2500
Mailing Address - Fax:402-717-2525
Practice Address - Street 1:7710 MERCY RD
Practice Address - Street 2:SUITE 406
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2346
Practice Address - Country:US
Practice Address - Phone:402-717-2500
Practice Address - Fax:402-717-2525
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1323363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant