Provider Demographics
NPI:1457427478
Name:WILLIAMS, SARAH MICHELLE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
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 1:1343 AIRPORT DR
Mailing Address - Street 2:# H-16
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-4720
Mailing Address - Country:US
Mailing Address - Phone:850-321-7736
Mailing Address - Fax:850-575-7592
Practice Address - Street 1:1343 AIRPORT DR
Practice Address - Street 2:# H-16
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-4720
Practice Address - Country:US
Practice Address - Phone:850-321-7736
Practice Address - Fax:850-575-7592
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL228895372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL228895OtherAHCA LISCENSE NUMBER