Provider Demographics
NPI:1306475553
Name:WILLIAMS, JULIETTE HERRINGTON
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:HERRINGTON
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 1:123 HIGH HILL ST
Mailing Address - Street 2:
Mailing Address - City:IRWINTON
Mailing Address - State:GA
Mailing Address - Zip Code:31042-2611
Mailing Address - Country:US
Mailing Address - Phone:478-946-2226
Mailing Address - Fax:
Practice Address - Street 1:101 WATSON DR STE B
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:31044-5508
Practice Address - Country:US
Practice Address - Phone:478-945-6522
Practice Address - Fax:478-864-1288
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN240177163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse