Individual
TINA IESHA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8416 TAFT ST, MERRILLVILLE, IN 46410-6122
(219) 750-9010
Mailing address
8416 TAFT ST, MERRILLVILLE, IN 46410-6122
(708) 310-9436
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28222770A
IN
163WG0600X
Gerontology Registered Nurse
Primary
AG12220078
IN
363L00000X
Nurse Practitioner
71013750A
IN
Other
Enumeration date
02/23/2023
Last updated
05/04/2024
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