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NPI Code Detail

MEDICARE: JOHNTAE WILLIAMS

MEDICARE: JOHNTAE WILLIAMS
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
1372500000XChore Provider
2372600000XAdult Companion
33747A0650XAttendant Care Provider
4376J00000XHomemaker
53747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1164356663
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHNTAE WILLIAMS
Provider Business Mailing Address
First Line : 2733 ASPEN CLUB AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-6430
Country : US
Telephone Number : 661-860-4694
Fax Number :
Provider Business Practice Location Address
First Line : 7517 COBAL CANYON LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-2903
Country : US
Telephone Number : 702-339-0356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ JOHNTAE WILLIAMS ” Practice Location

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