Provider Demographics
NPI:1619547932
Name:WILLIAMS, NASREN K
Entity Type:Individual
Prefix:MRS
First Name:NASREN
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NASREN
Other - Middle Name:K
Other - Last Name:MOHAMMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2921 34TH AVE S APT 254
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-5145
Mailing Address - Country:US
Mailing Address - Phone:701-541-7970
Mailing Address - Fax:
Practice Address - Street 1:2921 34TH AVE S APT 254
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-5145
Practice Address - Country:US
Practice Address - Phone:701-541-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant