Healthcare Provider Details

I. General information

NPI: 1689534653
Provider Name (Legal Business Name): HEATHER WILLIAMS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 37TH ST
VIENNA WV
26105-2524
US

IV. Provider business mailing address

602 37TH ST
VIENNA WV
26105-2524
US

V. Phone/Fax

Practice location:
  • Phone: 304-210-0667
  • Fax:
Mailing address:
  • Phone: 304-210-0667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: