Provider Demographics
NPI:1023690484
Name:WILLIAMS, ELIZABETH J
Entity type:Individual
Prefix:PROF
First Name:ELIZABETH
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 AVESTA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-2366
Mailing Address - Country:US
Mailing Address - Phone:304-807-8796
Mailing Address - Fax:304-471-2488
Practice Address - Street 1:1718 AVESTA DR
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-2366
Practice Address - Country:US
Practice Address - Phone:304-945-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant