Provider Demographics
NPI:1285930305
Name:ANTOINE-WILLIAMS, NADIA SHANNA (RN)
Entity type:Individual
Prefix:MRS
First Name:NADIA
Middle Name:SHANNA
Last Name:ANTOINE-WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:ANTOINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:395 GRAMATAN AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3233
Mailing Address - Country:US
Mailing Address - Phone:845-573-1353
Mailing Address - Fax:914-627-0171
Practice Address - Street 1:395 GRAMATAN AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3233
Practice Address - Country:US
Practice Address - Phone:845-573-1353
Practice Address - Fax:914-627-0171
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY677507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse