Provider Demographics
NPI:1053871558
Name:WILLIAMS, NIKIA (LVN)
Entity type:Individual
Prefix:
First Name:NIKIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 ASHLEY
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-7701
Mailing Address - Country:US
Mailing Address - Phone:903-559-1539
Mailing Address - Fax:
Practice Address - Street 1:2009 ASHLEY
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-7701
Practice Address - Country:US
Practice Address - Phone:903-559-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234209164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse