Provider Demographics
NPI:1124882444
Name:WILLIAMS, JANELLE NADINE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:NADINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TIMMOTHY DR
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-1233
Mailing Address - Country:US
Mailing Address - Phone:701-833-4238
Mailing Address - Fax:
Practice Address - Street 1:21 TIMMOTHY DR
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-1233
Practice Address - Country:US
Practice Address - Phone:701-833-4238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant