Provider Demographics
NPI:1528884947
Name:WILLIAMS, DEYSHA LEAH (RN-BSN)
Entity type:Individual
Prefix:
First Name:DEYSHA
Middle Name:LEAH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13141 226TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1733
Mailing Address - Country:US
Mailing Address - Phone:516-325-3793
Mailing Address - Fax:
Practice Address - Street 1:13141 226TH ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1733
Practice Address - Country:US
Practice Address - Phone:516-325-3793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY943672-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty