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General NPI Number Information
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NPI Number | 1174146286
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Entity Type | Individual
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Provider Name | KENYATTA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 3550 W CHEYENNE AVE # OFFICEA
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-8212
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Country | US
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Telephone | 702-931-1003
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Fax | 703-931-9274
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Provider Business Mailing Address
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Address Line | 3220 CRESCENDO ST
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City | LAS VEGAS
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State | NV
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Zip | 89129-6173
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Country | US
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Telephone | 702-427-6272
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Fax | 702-931-9274
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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