MEDICARE: KATHLEEN 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	314000000X	Skilled Nursing Facility	1064	AZ

General Provider Information

NPI Number	:	1952598302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHLEEN WILLIAMS

Provider Business Mailing Address
First Line	:	PO BOX 91471
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85752-1471
Country	:	US
Telephone Number	:	520-575-5829
Fax Number	:

Provider Business Practice Location Address
First Line	:	13750 N SEIFERT ESTATES DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85755-8654
Country	:	US
Telephone Number	:	520-575-5829
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	C B MORGAN
Credential	:
Telephone Number	:	602-589-8354

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	06/25/2008

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