Provider Demographics
NPI:1952842908
Name:WILLIAMS, LOIS JEAN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LOIS
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:LOIS
Other - Middle Name:SEABURY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:480 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-3901
Mailing Address - Country:US
Mailing Address - Phone:352-409-1580
Mailing Address - Fax:352-343-9262
Practice Address - Street 1:480 FERN AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3901
Practice Address - Country:US
Practice Address - Phone:352-409-1580
Practice Address - Fax:352-343-9262
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1358171164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse