Provider Demographics
NPI:1629443882
Name:WILLIAMS, BRIANNA PAIGE I (BS)
Entity Type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:PAIGE
Last Name:WILLIAMS
Suffix:I
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:BRIANNA
Other - Middle Name:PAIGE
Other - Last Name:WILLIAMS
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:925 HWY VV
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857
Mailing Address - Country:US
Mailing Address - Phone:573-888-5925
Mailing Address - Fax:573-888-9365
Practice Address - Street 1:925 HIGHWAY VV
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-0071
Practice Address - Country:US
Practice Address - Phone:573-888-5925
Practice Address - Fax:573-888-9365
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator