Individual
SHYESHA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17359 W JACKSON ST, GOODYEAR, AZ 85338-6047
(480) 526-3113
Mailing address
17359 W JACKSON ST, GOODYEAR, AZ 85338-6047
(480) 526-3113
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
TLP050174
AZ
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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