Provider Demographics
NPI:1790987741
Name:WILLIAMS, YOLANDA E (NP)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1705 CHRISTY DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-5195
Mailing Address - Country:US
Mailing Address - Phone:573-659-5570
Mailing Address - Fax:573-659-4570
Practice Address - Street 1:1705 CHRISTY DR
Practice Address - Street 2:SUITE 214
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5195
Practice Address - Country:US
Practice Address - Phone:573-659-5570
Practice Address - Fax:573-659-4570
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO103234163WX0601X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0601XNursing Service ProvidersRegistered NurseOtorhinolaryngology & Head-Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO801835434Medicare PIN