Provider Demographics
NPI:1902154651
Name:WILLIAMS, CHAMIKA LACHAUN
Entity Type:Individual
Prefix:
First Name:CHAMIKA
Middle Name:LACHAUN
Last Name:WILLIAMS
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 1:6708 ELDERMILL LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4435
Mailing Address - Country:US
Mailing Address - Phone:703-269-7716
Mailing Address - Fax:
Practice Address - Street 1:6708 ELDERMILL LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4435
Practice Address - Country:US
Practice Address - Phone:703-269-7716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide