Provider Demographics
NPI:1285455147
Name:WILLLIAMS, ANGELA PETRINA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:PETRINA
Last Name:WILLLIAMS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 MILNOR ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-5813
Mailing Address - Country:US
Mailing Address - Phone:904-405-9884
Mailing Address - Fax:
Practice Address - Street 1:1042 MILNOR ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-5813
Practice Address - Country:US
Practice Address - Phone:904-405-9884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9375368163W00000X, 163WH1000X, 163WM0705X, 163WS0121X, 163WW0000X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No163WW0000XNursing Service ProvidersRegistered NurseWound Care