Provider Demographics
NPI:1134718083
Name:WILLIAMS, KIA N
Entity type:Individual
Prefix:
First Name:KIA
Middle Name:N
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 1:195 WOODSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3159
Mailing Address - Country:US
Mailing Address - Phone:484-716-3819
Mailing Address - Fax:
Practice Address - Street 1:195 WOODSTOWN RD
Practice Address - Street 2:
Practice Address - City:WOOLWICH TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08085-3159
Practice Address - Country:US
Practice Address - Phone:856-214-2422
Practice Address - Fax:856-230-7174
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion