Provider Demographics
NPI:1104244664
Name:WILLIAMS, NATHAN (RN)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
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:PO BOX 75301
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236
Mailing Address - Country:US
Mailing Address - Phone:804-943-7358
Mailing Address - Fax:804-525-4189
Practice Address - Street 1:8014 MIDLOTHIAN TURNPIKE SUITE 202
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-525-4068
Practice Address - Fax:804-525-4189
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001235688163WC0400X, 163WH0200X, 163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult