Healthcare Provider Details

I. General information

NPI: 1376452714
Provider Name (Legal Business Name): RICHELLE ROLANDA WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N DECATUR RD
DECATUR GA
30033
US

IV. Provider business mailing address

7 EXECUTIVE PARK DR NE APT 1410
ATLANTA GA
30329-2265
US

V. Phone/Fax

Practice location:
  • Phone: 404-501-0000
  • Fax:
Mailing address:
  • Phone: 470-257-2614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number336472
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: