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General NPI Number Information
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NPI Number | 1619613171
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Entity Type | Individual
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Provider Name | DESTINY WILLIAMS NEMT
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Gender | Female
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 25030 GILMAR CT
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City | NORTH DINWIDDIE
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State | VA
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Zip | 23803-8615
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Country | US
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Telephone | 804-549-8318
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Fax |
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Provider Business Mailing Address
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Address Line | 25030 GILMAR CT
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City | NORTH DINWIDDIE
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State | VA
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Zip | 23803-8615
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Country | US
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Telephone | 804-549-8318
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Fax |
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | T62549501
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License Number State | VA
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