Provider Demographics
NPI:1205273737
Name:WILLIAMS, VIKI LOUISE (CRNFA)
Entity type:Individual
Prefix:MS
First Name:VIKI
Middle Name:LOUISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:MS
Other - First Name:VIKI
Other - Middle Name:LOUISE
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNFA
Mailing Address - Street 1:PO BOX 50924
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85076-0924
Mailing Address - Country:US
Mailing Address - Phone:480-545-2610
Mailing Address - Fax:480-545-2673
Practice Address - Street 1:9201 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3332
Practice Address - Country:US
Practice Address - Phone:480-545-2610
Practice Address - Fax:480-545-2673
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN112047163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant