Provider Demographics
NPI:1568792687
Name:WILLIAMS, LA-ANGEL STARR
Entity Type:Individual
Prefix:
First Name:LA-ANGEL
Middle Name:STARR
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 1:132 TATE TER
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1331
Mailing Address - Country:US
Mailing Address - Phone:330-785-5742
Mailing Address - Fax:
Practice Address - Street 1:132 TATE TER
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1331
Practice Address - Country:US
Practice Address - Phone:330-785-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH135774164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse