Provider Demographics
NPI:1760033674
Name:WILLIAMS, JOVITA
Entity Type:Individual
Prefix:MRS
First Name:JOVITA
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 1:2797 RODGERS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-8244
Mailing Address - Country:US
Mailing Address - Phone:252-217-8409
Mailing Address - Fax:
Practice Address - Street 1:2797 RODGERS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-8244
Practice Address - Country:US
Practice Address - Phone:252-217-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider