MEDICARE: MS. DANA LA'SHANE PINA 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	163WI0500X	Infusion Therapy Registered Nurse	101840	SC
2	163WG0000X	General Practice Registered Nurse	101840	SC

General Provider Information

NPI Number	:	1407650757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANA LA'SHANE PINA WILLIAMS RN

Provider Business Mailing Address
First Line	:	4410 CLAIBORNE SQ E STE 334
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-2074
Country	:	US
Telephone Number	:	843-557-4611
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 ISLAND COVE CT APT A
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-5604
Country	:	US
Telephone Number	:	843-557-4611
Fax Number	:

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

Provider Enumeration Date	:	04/03/2025
Last Update Date	:	04/03/2025

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