Provider Demographics
NPI:1124447925
Name:WILLIAMS, PATRICE DENISE (RN, ADN)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, ADN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GIBBS LOOP
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-4114
Mailing Address - Country:US
Mailing Address - Phone:843-209-9593
Mailing Address - Fax:
Practice Address - Street 1:201 GIBBS LOOP
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-4114
Practice Address - Country:US
Practice Address - Phone:843-209-9593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC221380163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health