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Individual

TRACY WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
818 ALHAMBRA RD, CLEVELAND, OH 44110-3108
(216) 732-1413
Mailing address
820 ALHAMBRA RD, CLEVELAND, OH 44110-3108
(216) 732-1413

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400000240701
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0229196
OH
01
400000240701
STATE TESTED NURSING ASSIST
OH
Enumeration date
02/20/2018
Last updated
06/16/2018
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