Provider Demographics
NPI:1790229219
Name:WILLIAMS, JAIMIE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JAIMIE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 ARBORLEE DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7095
Mailing Address - Country:US
Mailing Address - Phone:330-303-6239
Mailing Address - Fax:
Practice Address - Street 1:7261 ARBORLEE DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-7095
Practice Address - Country:US
Practice Address - Phone:330-303-6239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 311899163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse