MEDICARE: MS. NAOMI QAADIRA WILLIAMS CNA

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	376K00000X	Nurse's Aide	A00095502	MD

General Provider Information

NPI Number	:	1245590660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAOMI QAADIRA WILLIAMS CNA

Provider Business Mailing Address
First Line	:	11100 LAKE VICTORIA LN
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4258
Country	:	US
Telephone Number	:	240-423-0794
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 LAKE VICTORIA LN
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4258
Country	:	US
Telephone Number	:	240-423-0794
Fax Number	:

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

Provider Enumeration Date	:	05/18/2012
Last Update Date	:	05/18/2012

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