Healthcare Provider Details

I. General information

NPI: 1265395172
Provider Name (Legal Business Name): JEANETTE MERIE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 6TH ST SW APT 506
WASHINGTON DC
20024-2666
US

IV. Provider business mailing address

2602 BRINKLEY RD APT 1016
FORT WASHINGTON MD
20744-1918
US

V. Phone/Fax

Practice location:
  • Phone: 240-393-0457
  • Fax:
Mailing address:
  • Phone: 240-393-0457
  • Fax: 240-393-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: