Provider Demographics
NPI:1578246534
Name:WILLIAMS, JODI ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:60 ACADEMY RD BLDG D
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3103
Mailing Address - Country:US
Mailing Address - Phone:518-426-2600
Mailing Address - Fax:518-426-2638
Practice Address - Street 1:60 ACADEMY RD BLDG D
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3103
Practice Address - Country:US
Practice Address - Phone:518-426-2600
Practice Address - Fax:518-426-2638
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY740633163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse