Provider Demographics
NPI:1588150205
Name:WILLIAMS, PAGE K (RN)
Entity type:Individual
Prefix:
First Name:PAGE
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:520 MARYVILLE CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5820
Mailing Address - Country:US
Mailing Address - Phone:314-364-4006
Mailing Address - Fax:314-364-3747
Practice Address - Street 1:15945 CLAYTON RD STE 310
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2493
Practice Address - Country:US
Practice Address - Phone:636-893-1356
Practice Address - Fax:636-893-1358
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO153176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse