Provider Demographics
NPI:1487475448
Name:WILLIAMS-EDMONDS, RANADA ANN
Entity type:Individual
Prefix:
First Name:RANADA
Middle Name:ANN
Last Name:WILLIAMS-EDMONDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5645 E RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-4967
Mailing Address - Country:US
Mailing Address - Phone:317-760-5066
Mailing Address - Fax:317-550-0801
Practice Address - Street 1:5645 E RAYMOND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-4967
Practice Address - Country:US
Practice Address - Phone:317-760-5066
Practice Address - Fax:317-550-0801
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN282050630A163W00000X
IN28205630A163WC0200X, 163WC1600X, 163WH0200X
IN376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No376K00000XNursing Service Related ProvidersNurse's Aide