Provider Demographics
NPI:1982453205
Name:WILLIAMS, LORRAINE JANELLE
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:JANELLE
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:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:SOUTH HEART
Mailing Address - State:ND
Mailing Address - Zip Code:58655-0017
Mailing Address - Country:US
Mailing Address - Phone:701-502-1007
Mailing Address - Fax:
Practice Address - Street 1:401 6TH ST NW # 1
Practice Address - Street 2:
Practice Address - City:SOUTH HEART
Practice Address - State:ND
Practice Address - Zip Code:58655-9506
Practice Address - Country:US
Practice Address - Phone:701-502-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care