Healthcare Provider Details

I. General information

NPI: 1184952574
Provider Name (Legal Business Name): DANIELLE M WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 EUBANK BLVD NE APT. 2906
ALBUQUERQUE NM
87111-6122
US

IV. Provider business mailing address

5800 EUBANK BLVD NE APT. 2906
ALBUQUERQUE NM
87111-6122
US

V. Phone/Fax

Practice location:
  • Phone: 505-903-1868
  • Fax:
Mailing address:
  • Phone: 505-903-1868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: