Provider Demographics
NPI:1134434483
Name:WILLIAMS, SYLVIA L (LPN)
Entity type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:L
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 1:211 GLENSIDE CT
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-2733
Mailing Address - Country:US
Mailing Address - Phone:937-248-6191
Mailing Address - Fax:
Practice Address - Street 1:211 GLENSIDE CT
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-2733
Practice Address - Country:US
Practice Address - Phone:937-248-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 115367 M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse