Individual
IVETTA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
422 IVY CREST DR, DALLAS, GA 30157-5528
(678) 363-0761
Mailing address
422 IVY CREST DR, DALLAS, GA 30157-5528
(678) 363-0761
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
RN166709
GA
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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