Provider Demographics
NPI:1932912946
Name:WILLIAMS, JANELLE H
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:H
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 1:965 LOCH LOMOND CIR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0405
Mailing Address - Country:US
Mailing Address - Phone:980-230-7883
Mailing Address - Fax:
Practice Address - Street 1:965 LOCH LOMOND CIR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0405
Practice Address - Country:US
Practice Address - Phone:980-230-7883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor