Individual
MS. LINDA RAE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
127 GILEAD ST, SHADY SPRING, WV 25918-2004
(304) 763-6155
(304) 763-6156
Mailing address
PO BOX 2004, SHADY SPRING, WV 25918-2004
(304) 763-6155
(304) 763-6156
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
17263
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722480
BLUE CROSS BLUE SHIELD
WV
01
—
550771337001
TRICARE
WV
05
—
5710351000
—
WV
Enumeration date
01/05/2007
Last updated
07/08/2007
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