Provider Demographics
NPI:1457796872
Name:WILLIAMS, SANDRA S (RN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LUCY P EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:SC
Mailing Address - Zip Code:29388-8220
Mailing Address - Country:US
Mailing Address - Phone:864-476-3174
Mailing Address - Fax:864-476-7067
Practice Address - Street 1:200 LUCY P EDWARDS RD
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388-8220
Practice Address - Country:US
Practice Address - Phone:864-476-3174
Practice Address - Fax:864-476-7067
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26040163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool