Healthcare Provider Details

I. General information

NPI: 1538307558
Provider Name (Legal Business Name): CAROLYN WILLIAMS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 COUNTRY BROOK DR
MONTGOMERY AL
36116-3844
US

IV. Provider business mailing address

2716 COUNTRY BROOK DR
MONTGOMERY AL
36116-3844
US

V. Phone/Fax

Practice location:
  • Phone: 334-549-4282
  • Fax:
Mailing address:
  • Phone: 334-549-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: