Provider Demographics
NPI:1386607620
Name:WILLIAMS, LINDA LORRAINE (NP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LORRAINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:LORRAINE
Other - Last Name:WILLIAMS-MITCHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:3912 MOONSHINE FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89085-4487
Mailing Address - Country:US
Mailing Address - Phone:702-586-5760
Mailing Address - Fax:
Practice Address - Street 1:4771 W CRAIG RD
Practice Address - Street 2:TAKE CARE HEALTH SYSTEMS
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030
Practice Address - Country:US
Practice Address - Phone:702-250-8641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily