Provider Demographics
NPI:1538877501
Name:WILLIAMS, SHAUNETEKA
Entity type:Individual
Prefix:
First Name:SHAUNETEKA
Middle Name:
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 1:1237 NE 39TH RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-0903
Mailing Address - Country:US
Mailing Address - Phone:352-286-6903
Mailing Address - Fax:352-632-5031
Practice Address - Street 1:217 SE 1ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2161
Practice Address - Country:US
Practice Address - Phone:352-632-5032
Practice Address - Fax:352-632-5031
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9394922163WC1600X, 163WH0500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis