Individual
LAQUANIA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
470 COUNTY ROAD 471, VARDAMAN, MS 38878-9770
(662) 628-0621
Mailing address
470 COUNTY ROAD 471, VARDAMAN, MS 38878-9770
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
901863
MS
363LP2300X
Primary Care Nurse Practitioner
Primary
95008190
CA
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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