Provider Demographics
NPI:1447002118
Name:WILLIAMS, DONNETTE M
Entity type:Individual
Prefix:
First Name:DONNETTE
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DONNETTE
Other - Middle Name:M
Other - Last Name:LEMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 WOODS EDGE DR APT G
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-5807
Mailing Address - Country:US
Mailing Address - Phone:269-363-8545
Mailing Address - Fax:
Practice Address - Street 1:950 WOODS EDGE DR APT A
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-5807
Practice Address - Country:US
Practice Address - Phone:269-479-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide