Provider Demographics
NPI:1902580996
Name:WILLIAMS, ALYSSA (LPN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CRANBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-2505
Mailing Address - Country:US
Mailing Address - Phone:609-529-6641
Mailing Address - Fax:
Practice Address - Street 1:2021 NOTTINGHAM WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3029
Practice Address - Country:US
Practice Address - Phone:609-587-1059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP07915500164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse