Provider Demographics
NPI:1407694474
Name:WILLIAMS, LAURIE JANE
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:JANE
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 1:95 SHARON ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:OH
Mailing Address - Zip Code:44875-1144
Mailing Address - Country:US
Mailing Address - Phone:419-685-8808
Mailing Address - Fax:
Practice Address - Street 1:95 SHARON ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-1144
Practice Address - Country:US
Practice Address - Phone:419-685-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide