Provider Demographics
NPI:1689820912
Name:WILLIAMS, KITA LAINI (MD)
Entity type:Individual
Prefix:
First Name:KITA
Middle Name:LAINI
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KITA
Other - Middle Name:LAINI
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9107 BRENTMEADE BLVD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8525
Mailing Address - Country:US
Mailing Address - Phone:615-588-0605
Mailing Address - Fax:615-219-2285
Practice Address - Street 1:630 EATON AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2767
Practice Address - Country:US
Practice Address - Phone:513-867-2000
Practice Address - Fax:513-867-2119
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220461932084N0400X
TN480512084N0400X
AL458162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4334873OtherBLUE CROSS-BLUE SHIELD
TN1529400Medicaid
TNP01067308OtherRR MEDICARE
TN103I133204Medicare PIN