MEDICARE: MRS. DEBRA A WILLIAMS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	127531-030	WI
2	163WH0200X	Home Health Registered Nurse	127531-030	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326007907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA A WILLIAMS RN

Provider Business Mailing Address
First Line	:	3695 VINLAND CENTER RD
Second Line	:
City	:	NEENAH
State	:	WI
Zip	:	54956-9043
Country	:	US
Telephone Number	:	920-836-2072
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 CITY CTR
Second Line	:
City	:	OSHKOSH
State	:	WI
Zip	:	54901-4830
Country	:	US
Telephone Number	:	920-456-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	08/06/2010

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