Individual
TANEISHA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 DAVIS ST, FAYETTEVILLE, NC 28305-5355
(910) 257-2351
Mailing address
PO BOX 40602, FAYETTEVILLE, NC 28309-0602
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2227863
—
NC
Enumeration date
07/14/2021
Last updated
07/14/2021
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