Provider Demographics
NPI:1023661295
Name:WILLIAMS, WENDY RENEA (LVN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:RENEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:RENEA
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:14895 STATE HIGHWAY 155
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763-6761
Mailing Address - Country:US
Mailing Address - Phone:936-245-7795
Mailing Address - Fax:
Practice Address - Street 1:14895 STATE HIGHWAY 155
Practice Address - Street 2:
Practice Address - City:FRANKSTON
Practice Address - State:TX
Practice Address - Zip Code:75763-6761
Practice Address - Country:US
Practice Address - Phone:936-245-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302528164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse