Provider Demographics
NPI:1811415896
Name:WILLIAMS, NAKASHA SHANISE
Entity Type:Individual
Prefix:
First Name:NAKASHA
Middle Name:SHANISE
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 1:3695 DRAKE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39739-8995
Mailing Address - Country:US
Mailing Address - Phone:662-361-2355
Mailing Address - Fax:
Practice Address - Street 1:3695 DRAKE HILL RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:MS
Practice Address - Zip Code:39739-8995
Practice Address - Country:US
Practice Address - Phone:662-361-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion