Provider Demographics
NPI:1932462876
Name:WILLIAMS, PRISCILLA (NURSE)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14931 WOODLORE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1553
Mailing Address - Country:US
Mailing Address - Phone:225-954-2200
Mailing Address - Fax:
Practice Address - Street 1:7173A FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4549
Practice Address - Country:US
Practice Address - Phone:225-922-3218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN070470163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health