Provider Demographics
NPI:1578060745
Name:WILLIAMS-NELSON, KELISHIA LENETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KELISHIA
Middle Name:LENETTE
Last Name:WILLIAMS-NELSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 INWOOD RD STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5329
Mailing Address - Country:US
Mailing Address - Phone:469-245-3564
Mailing Address - Fax:469-293-1102
Practice Address - Street 1:13450 INWOOD RD STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5329
Practice Address - Country:US
Practice Address - Phone:469-245-3564
Practice Address - Fax:469-293-1102
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX808979163WA2000X, 163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator