Provider Demographics
NPI:1811934854
Name:WILLIAMS, LECHELLE DELEA (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:LECHELLE
Middle Name:DELEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 GILLHAM RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2667
Mailing Address - Country:US
Mailing Address - Phone:816-234-1633
Mailing Address - Fax:816-855-1948
Practice Address - Street 1:2410 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2667
Practice Address - Country:US
Practice Address - Phone:816-234-1633
Practice Address - Fax:816-855-1948
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO121017363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP55091Medicare UPIN
MO269B698Medicare ID - Type Unspecified