Healthcare Provider Details

I. General information

NPI: 1003639469
Provider Name (Legal Business Name): LASHON SHEREMA WILLIAMS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER AMC HI
96859-5001
US

IV. Provider business mailing address

3284 SUTHERLAND CT
WHITE PLAINS MD
20695-4449
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8601
  • Fax:
Mailing address:
  • Phone: 301-257-3962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number506902
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number506902
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: