Provider Demographics
NPI:1891526125
Name:WILLIAMS, TIERRA
Entity type:Individual
Prefix:
First Name:TIERRA
Middle Name:
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 1:3700 9TH STREET SE
Mailing Address - Street 2:APT 429
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4025
Mailing Address - Country:US
Mailing Address - Phone:202-779-7228
Mailing Address - Fax:
Practice Address - Street 1:3700 9TH ST SE
Practice Address - Street 2:APT 429
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4025
Practice Address - Country:US
Practice Address - Phone:202-779-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant