Provider Demographics
NPI:1649860032
Name:WILLIAMS, FLETCHER (CCHW)
Entity type:Individual
Prefix:
First Name:FLETCHER
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 CHURCH ST STE C
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2448
Mailing Address - Country:US
Mailing Address - Phone:757-227-4677
Mailing Address - Fax:
Practice Address - Street 1:1446 CHURCH ST STE C
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2448
Practice Address - Country:US
Practice Address - Phone:757-227-4677
Practice Address - Fax:757-961-4083
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2875172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker