Provider Demographics
NPI:1518296649
Name:WILLIAMS, LINDA DENISE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:DENISE
Other - Last Name:CHANNEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MEDICAL ASSISTANT
Mailing Address - Street 1:14211 E 1ST DR
Mailing Address - Street 2:UNIT 304
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-3806
Mailing Address - Country:US
Mailing Address - Phone:303-619-5159
Mailing Address - Fax:
Practice Address - Street 1:14701 E EXPOSITION AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2623
Practice Address - Country:US
Practice Address - Phone:303-619-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-20
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47273164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse