Provider Demographics
NPI:1154184067
Name:WILLIAMS, VERNELL (CNA)
Entity type:Individual
Prefix:
First Name:VERNELL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 SKYLAND GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3866
Mailing Address - Country:US
Mailing Address - Phone:678-437-0224
Mailing Address - Fax:
Practice Address - Street 1:2085 SKYLAND GLEN DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3866
Practice Address - Country:US
Practice Address - Phone:678-437-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20233306251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health