Provider Demographics
NPI:1023670940
Name:WILLIAMS, ATLANTA ENJOLI (RN)
Entity type:Individual
Prefix:
First Name:ATLANTA
Middle Name:ENJOLI
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BUCKTAIL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-6131
Mailing Address - Country:US
Mailing Address - Phone:302-312-3696
Mailing Address - Fax:
Practice Address - Street 1:240 BUCKTAIL DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-6131
Practice Address - Country:US
Practice Address - Phone:302-312-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0051891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse