Provider Demographics
NPI:1114388949
Name:WILLIAMS, NADALYN E (RN, BSN)
Entity type:Individual
Prefix:
First Name:NADALYN
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17167 FIVE POINTS ST
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2119
Mailing Address - Country:US
Mailing Address - Phone:313-265-8368
Mailing Address - Fax:
Practice Address - Street 1:17167 FIVE POINTS ST
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2119
Practice Address - Country:US
Practice Address - Phone:313-265-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704308844163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse