Provider Demographics
NPI:1518272095
Name:WILLIAMS, PIRA ALEXIS (LPN)
Entity Type:Individual
Prefix:MS
First Name:PIRA
Middle Name:ALEXIS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5255 GREENCROFT DR
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1922
Mailing Address - Country:US
Mailing Address - Phone:937-312-5077
Mailing Address - Fax:
Practice Address - Street 1:5255 GREENCROFT DR
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-1922
Practice Address - Country:US
Practice Address - Phone:937-312-5077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2013-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 125422 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse