Provider Demographics
NPI:1639718281
Name:WILLIAMS, ARNETTA
Entity Type:Individual
Prefix:
First Name:ARNETTA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 COUNTRY LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:OH
Mailing Address - Zip Code:45122-8428
Mailing Address - Country:US
Mailing Address - Phone:513-545-8111
Mailing Address - Fax:
Practice Address - Street 1:505 COUNTRY LAKE CIR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:OH
Practice Address - Zip Code:45122-8428
Practice Address - Country:US
Practice Address - Phone:513-545-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide