Provider Demographics
NPI:1609387265
Name:WILLIAMS, FAAKHIRAH B (LPN)
Entity Type:Individual
Prefix:MS
First Name:FAAKHIRAH
Middle Name:B
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:FAAKHIRAH
Other - Middle Name:B
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 SALINGER DR
Mailing Address - Street 2:
Mailing Address - City:LITHOPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:43136-7505
Mailing Address - Country:US
Mailing Address - Phone:614-620-5958
Mailing Address - Fax:
Practice Address - Street 1:920 SALINGER DR
Practice Address - Street 2:
Practice Address - City:LITHOPOLIS
Practice Address - State:OH
Practice Address - Zip Code:43136-7505
Practice Address - Country:US
Practice Address - Phone:614-620-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-22
Last Update Date:2017-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.162578.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse