Provider Demographics
NPI:1871809988
Name:WILLIAMS, ANA R (ASSISTANT NURSE)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ASSISTANT NURSE
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:R
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASSISTANT NURSE
Mailing Address - Street 1:40 ANNUNCIATION RD APT Z
Mailing Address - Street 2:
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-1867
Mailing Address - Country:US
Mailing Address - Phone:617-959-1332
Mailing Address - Fax:617-516-8934
Practice Address - Street 1:40 ANNUNCIATION RD APT Z
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-1867
Practice Address - Country:US
Practice Address - Phone:617-959-1332
Practice Address - Fax:617-516-8934
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20960P1097374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA20960-P1097OtherMA INSTITUTE FOR HEALTH CAREERS