Provider Demographics
NPI:1154404630
Name:WILLIAMS, KATHLEEN MECHELE (RN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MECHELE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 NW WOLF RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-7782
Mailing Address - Country:US
Mailing Address - Phone:580-919-9199
Mailing Address - Fax:
Practice Address - Street 1:4301 MOW-WAY RD
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-6300
Practice Address - Country:US
Practice Address - Phone:580-458-2200
Practice Address - Fax:580-458-2314
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0081372163W00000X
OKRN81372163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse