Provider Demographics
NPI:1982202115
Name:WILLIAMS, LONNEKKA PRITICE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LONNEKKA
Middle Name:PRITICE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3798 CATALPA LN
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-1921
Mailing Address - Country:US
Mailing Address - Phone:404-397-8916
Mailing Address - Fax:
Practice Address - Street 1:3798 CATALPA LN
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-1921
Practice Address - Country:US
Practice Address - Phone:404-397-8916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCH008638104100000X, 251S00000X, 311ZA0620X, 372600000X
GALPN087540171M00000X, 251B00000X, 251E00000X, 251G00000X, 253Z00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No372600000XNursing Service Related ProvidersAdult Companion