Provider Demographics
NPI:1841362423
Name:WILLIAMS, DENISE EMELIA (RN)
Entity type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:EMELIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:EMELIA
Other - Last Name:VIGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8961 DANIELS CENTER DRIVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-0314
Mailing Address - Country:US
Mailing Address - Phone:239-433-6700
Mailing Address - Fax:239-433-6703
Practice Address - Street 1:8961 DANIELS CENTER DRIVE
Practice Address - Street 2:SUITE 401
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-0314
Practice Address - Country:US
Practice Address - Phone:239-433-6700
Practice Address - Fax:239-433-6703
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3157712163W00000X
FLRN3157712163W00000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811664400Medicaid