MEDICARE: VONETTA 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
1	376K00000X	Nurse's Aide	413697	NC

General Provider Information

NPI Number	:	1790486561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VONETTA WILLIAMS

Provider Business Mailing Address
First Line	:	3054 WESTMINSTER RD
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28360-9076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3054 WESTMINSTER RD
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28360-9076
Country	:	US
Telephone Number	:	910-624-3823
Fax Number	:

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

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	03/16/2023

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Directions to “ VONETTA WILLIAMS ” Practice Location

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