Provider Demographics
NPI:1023719135
Name:WILLIAMS, KASHIA SIMONE
Entity type:Individual
Prefix:
First Name:KASHIA
Middle Name:SIMONE
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 1:412 PEAR ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-2312
Mailing Address - Country:US
Mailing Address - Phone:404-326-3982
Mailing Address - Fax:
Practice Address - Street 1:412 PEAR ORCHARD RD
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2312
Practice Address - Country:US
Practice Address - Phone:404-326-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN078325251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care