Provider Demographics
NPI:1598314700
Name:WILLIAMS, TERESSA ANN (RN)
Entity Type:Individual
Prefix:
First Name:TERESSA
Middle Name:ANN
Last Name:WILLIAMS
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 1:24089 J TER
Mailing Address - Street 2:
Mailing Address - City:WAKEENEY
Mailing Address - State:KS
Mailing Address - Zip Code:67672-2719
Mailing Address - Country:US
Mailing Address - Phone:785-769-4154
Mailing Address - Fax:
Practice Address - Street 1:24089 J TER
Practice Address - Street 2:
Practice Address - City:WAKEENEY
Practice Address - State:KS
Practice Address - Zip Code:67672-2719
Practice Address - Country:US
Practice Address - Phone:785-769-4154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider