Provider Demographics
NPI:1932814761
Name:WILLIAMS, MONTEONA BRE'L
Entity type:Individual
Prefix:
First Name:MONTEONA
Middle Name:BRE'L
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 1:3230 S BUFFALO DR
Mailing Address - Street 2:SUITE 105 UNIT #2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2505
Mailing Address - Country:US
Mailing Address - Phone:702-943-8898
Mailing Address - Fax:
Practice Address - Street 1:3230 S BUFFALO DR
Practice Address - Street 2:SUITE 105 UNIT #2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2505
Practice Address - Country:US
Practice Address - Phone:702-943-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant