Provider Demographics
NPI:1568011047
Name:WILLIAMS, TAMME M
Entity Type:Individual
Prefix:
First Name:TAMME
Middle Name:M
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 1:1510 S PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-1145
Mailing Address - Country:US
Mailing Address - Phone:816-313-7752
Mailing Address - Fax:
Practice Address - Street 1:1510 S PLEASANT ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-1145
Practice Address - Country:US
Practice Address - Phone:816-313-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider