MEDICARE: MRS. LINDSEY ANN WILLIAMS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	704191	CA

General Provider Information

NPI Number	:	1104142892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSEY ANN WILLIAMS RN

Provider Business Mailing Address
First Line	:	1218 PECOS WAY
Second Line	:
City	:	PLUMAS LAKE
State	:	CA
Zip	:	95961-8904
Country	:	US
Telephone Number	:	530-415-8286
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 PECOS WAY
Second Line	:
City	:	PLUMAS LAKE
State	:	CA
Zip	:	95961-8904
Country	:	US
Telephone Number	:	530-415-8286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	04/20/2010

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