LAQUANIA WILLIAMS (NPI# 1063912046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063912046 |
| Entity Type | Individual |
| Full Name | LAQUANIA WILLIAMS |
| Credential | NURSE PRACTITIONER |
| Practice Address |
470 County Road 471 Vardaman MS 38878-9770 |
| Practice Telephone | 6626280621 |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2018-02-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
901863 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
95008190 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
470 COUNTY ROAD 471 |
| City | VARDAMAN |
| State | MS |
| Zip Code | 38878-9770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881077717 | Walter Edington | Nurse Practitioner | 310 W Sweet Potato St, Vardaman, MS 38878-8405 | 2015-07-09 |
| 1396762860 | Freds Stores of Tennessee Inc | Pharmacy | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2006-07-17 |
| 1780235614 | Scpg Mississippi LLC | Pharmacy | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2019-09-23 |
| 1659898328 | Barry Dayton Criddle | Pharmacist | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2017-08-24 |
| 1164731022 | John Jasper Adams | Pharmacist | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2010-09-27 |
| 1114235223 | William Eldon Hester | Pharmacist | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2010-09-23 |
| 1538179536 | Jaime D Castillo Jr. | Internal Medicine | 416 E Sweet Potato St, Vardaman, MS 38878-9503 | 2006-08-09 |
| 1134236870 | Southern Health Corp of Houston, Inc. | Clinic/Center | 416 E Sweet Potato St, Vardaman, MS 38878-9503 | 2006-08-25 |
| 1780791673 | Mary Anne Hendrix | Nurse Practitioner | 416 E Sweet Potato St, 416 E Sweet Potato St, Vardaman, MS 38878-9503 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881077717 | Walter Edington | Nurse Practitioner | 310 W Sweet Potato St, Vardaman, MS 38878-8405 | 2015-07-09 |
| 1538179536 | Jaime D Castillo Jr. | Internal Medicine | 416 E Sweet Potato St, Vardaman, MS 38878-9503 | 2006-08-09 |
| 1396762860 | Freds Stores of Tennessee Inc | Pharmacy | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2006-07-17 |
| 1780235614 | Scpg Mississippi LLC | Pharmacy | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2019-09-23 |
| 1659898328 | Barry Dayton Criddle | Pharmacist | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2017-08-24 |
| 1164731022 | John Jasper Adams | Pharmacist | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2010-09-27 |
| 1114235223 | William Eldon Hester | Pharmacist | 101 W Sweet Potato St, Vardaman, MS 38878-9433 | 2010-09-23 |
| 1134236870 | Southern Health Corp of Houston, Inc. | Clinic/Center | 416 E Sweet Potato St, Vardaman, MS 38878-9503 | 2006-08-25 |
| 1780791673 | Mary Anne Hendrix | Nurse Practitioner | 416 E Sweet Potato St, 416 E Sweet Potato St, Vardaman, MS 38878-9503 | 2006-08-24 |
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.