Provider Demographics
NPI:1881499978
Name:WILLIAMS, SHARISS (MOBILE PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:SHARISS
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MOBILE PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 N BROOKFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-3008
Mailing Address - Country:US
Mailing Address - Phone:574-498-4375
Mailing Address - Fax:
Practice Address - Street 1:1626 N BROOKFIELD ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-3008
Practice Address - Country:US
Practice Address - Phone:574-498-4375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC7K5X2K3246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy