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General NPI Number Information
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NPI Number | 1659179042
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Entity Type | Individual
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Provider Name | JOHNATHAN L WILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1601 N 28TH ST
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City | LINCOLN
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State | NE
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Zip | 68503-1504
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Country | US
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Telephone | 402-484-1508
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Fax |
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Provider Business Mailing Address
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Address Line | 2340 W O ST TRLR 25
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City | LINCOLN
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State | NE
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Zip | 68528-1143
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Country | US
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Telephone | 402-298-0600
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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 | 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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