Provider Demographics
NPI:1922114156
Name:WILLIAMS, JAIMEE M (RN)
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:M
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:PO BOX 1723
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-0034
Mailing Address - Country:US
Mailing Address - Phone:706-310-7175
Mailing Address - Fax:
Practice Address - Street 1:10 S BARNETT SHOALS RD
Practice Address - Street 2:SUITE C
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-2500
Practice Address - Country:US
Practice Address - Phone:706-310-7175
Practice Address - Fax:706-310-7176
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAINV-8-06-988335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5787400001Medicare PIN
GA5787400001Medicare NSC