Provider Demographics
NPI:1679853725
Name:WILLIAMS, TASHIA LASHA (RN)
Entity type:Individual
Prefix:
First Name:TASHIA
Middle Name:LASHA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TAIUSHA
Other - Middle Name:LASHA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:6942 LAKEVIEW BLVD
Mailing Address - Street 2:APT 21115
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-6634
Mailing Address - Country:US
Mailing Address - Phone:734-673-7830
Mailing Address - Fax:
Practice Address - Street 1:5250 JOHN R ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-4030
Practice Address - Country:US
Practice Address - Phone:313-831-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704283743163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse