Provider Demographics
NPI:1881357838
Name:WILLIAMS, DANIELLE LAVONNE OPAL (BSN, RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LAVONNE OPAL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5216 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3541
Mailing Address - Country:US
Mailing Address - Phone:918-360-2989
Mailing Address - Fax:
Practice Address - Street 1:5216 E 90TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3541
Practice Address - Country:US
Practice Address - Phone:918-360-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK208657163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse