Edwana Deatrice Williams

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

NV20171137651 Issued in NV

Practice address

3809 Hayward Field Rd
Las Vegas, NV 89115-1571

Phone

(559) 644-6150

NPI assigned

Jun 9, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144759358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 HAYWARD FIELD RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891151571",
            "telephone_number": "559-644-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 HAYWARD FIELD RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891151571",
            "telephone_number": "559-644-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "EDWANA",
        "middle_name": "DEATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "2003674062101",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NV",
            "license": "NV20171137651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorsereese Denise Williams
• Douglas Williams
• Duncan James Williams, DO
• Ebony Williams
• Edna Williams
• Edward Williams
• Elaine Williams
• Elissa Williams
• Elizabeth Anne Williams
• Ellen Williams

• Home Health Aide in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Home Health Aide in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.