Provider Demographics
NPI:1942839949
Name:WILLIAMS, VICTORIA (RN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
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 1:109 NW MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4079
Mailing Address - Country:US
Mailing Address - Phone:972-679-4097
Mailing Address - Fax:
Practice Address - Street 1:109 NW MAIN ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4079
Practice Address - Country:US
Practice Address - Phone:972-679-4097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 133NN1002X, 372500000X, 376J00000X, 390200000X
TX661864163WC0400X, 163WC1500X, 163WC1600X, 163WD1100X, 163WH0500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program