Provider Demographics
NPI:1891114203
Name:WILLIAMS, ALYSHA LYNN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ALYSHA
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NOTRE DAME ST APT 5
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1231
Mailing Address - Country:US
Mailing Address - Phone:617-642-7022
Mailing Address - Fax:
Practice Address - Street 1:8 NOTRE DAME ST APT 5
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1231
Practice Address - Country:US
Practice Address - Phone:617-642-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN87533164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse