Provider Demographics
NPI:1962895946
Name:WILLIAMS, COURTNEI
Entity type:Individual
Prefix:
First Name:COURTNEI
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 1:4267 CHAMBLEE TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084
Mailing Address - Country:US
Mailing Address - Phone:678-744-6296
Mailing Address - Fax:
Practice Address - Street 1:4267 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084
Practice Address - Country:US
Practice Address - Phone:678-744-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-14
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic