Healthcare Provider Details

I. General information

NPI: 1144167685
Provider Name (Legal Business Name): MS. PERTRINA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 WILLIAMS AVE
MEMPHIS TN
38126-5812
US

IV. Provider business mailing address

PO BOX 11037
MEMPHIS TN
38111-0037
US

V. Phone/Fax

Practice location:
  • Phone: 901-947-2136
  • Fax: 901-752-8843
Mailing address:
  • Phone: 901-947-2136
  • Fax: 901-752-8843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: