Healthcare Provider Details

I. General information

NPI: 1831317189
Provider Name (Legal Business Name): TAWANDA WILLIAMS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 HUNT ST STE 435
DETROIT MI
48207-5602
US

IV. Provider business mailing address

2200 HUNT ST STE 435
DETROIT MI
48207-5602
US

V. Phone/Fax

Practice location:
  • Phone: 313-980-2500
  • Fax: 313-980-2500
Mailing address:
  • Phone: 313-980-2500
  • Fax: 313-731-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704293812
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: