Provider Demographics
NPI:1386488252
Name:WILLIAMS, JERA N (RN)
Entity type:Individual
Prefix:
First Name:JERA
Middle Name:N
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 1:2100 N ZIMMERS ST
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-3244
Mailing Address - Country:US
Mailing Address - Phone:806-663-1717
Mailing Address - Fax:
Practice Address - Street 1:2100 N ZIMMERS ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-3244
Practice Address - Country:US
Practice Address - Phone:806-663-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX816142253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care