MEDICARE: PRISCILLA WILLIAMS NURSE

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	163WC1500X	Community Health Registered Nurse	RN070470	LA

General Provider Information

NPI Number	:	1932462876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA WILLIAMS NURSE

Provider Business Mailing Address
First Line	:	14931 WOODLORE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-1553
Country	:	US
Telephone Number	:	225-954-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	7173A FLORIDA BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-4549
Country	:	US
Telephone Number	:	225-922-3218
Fax Number	:

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

Provider Enumeration Date	:	06/15/2012
Last Update Date	:	06/15/2012

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