Provider Demographics
NPI:1952913212
Name:WILLIAMS, TAMIESHA YVETTE (CERTIFEID NURSES AID)
Entity Type:Individual
Prefix:
First Name:TAMIESHA
Middle Name:YVETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CERTIFEID NURSES AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 FENWICK ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-2628
Mailing Address - Country:US
Mailing Address - Phone:413-275-5421
Mailing Address - Fax:
Practice Address - Street 1:38 FENWICK ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-2628
Practice Address - Country:US
Practice Address - Phone:800-994-7892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty