Provider Demographics
NPI:1942407564
Name:WILLIAMS-JOHNSON, ANIKA KEYSHAWN (ST)
Entity Type:Individual
Prefix:MRS
First Name:ANIKA
Middle Name:KEYSHAWN
Last Name:WILLIAMS-JOHNSON
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 APRIL LN
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-9363
Mailing Address - Country:US
Mailing Address - Phone:336-616-0425
Mailing Address - Fax:
Practice Address - Street 1:124 APRIL LN
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-9363
Practice Address - Country:US
Practice Address - Phone:336-616-0425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist