Provider Demographics
NPI:1427825751
Name:LAY, WILHEMENIA HARRIS (CNA)
Entity type:Individual
Prefix:MRS
First Name:WILHEMENIA
Middle Name:HARRIS
Last Name:LAY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 FAIRFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-0517
Mailing Address - Country:US
Mailing Address - Phone:706-461-0320
Mailing Address - Fax:
Practice Address - Street 1:182 FAIRFIELD CIR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-0517
Practice Address - Country:US
Practice Address - Phone:706-461-0320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACNA0030021654251E00000X
GACN0030021654376K00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No376K00000XNursing Service Related ProvidersNurse's Aide