Healthcare Provider Details

I. General information

NPI: 1922927714
Provider Name (Legal Business Name): KEETRA DIONNE WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3923 MINNESOTA AVE NE
WASHINGTON DC
20019-2662
US

IV. Provider business mailing address

15208 LINCOLNSHIRE PL
UPPER MARLBORO MD
20774-8082
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-5310
  • Fax:
Mailing address:
  • Phone: 301-792-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN68482
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: