Basic Information
Provider Information
NPI: 1699254425
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS-DYER
FirstName: NADINE
MiddleName: JOAN
NamePrefix: MRS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20518 FLORA FAUNA DR
Address2:  
City: HUMBLE
State: TX
PostalCode: 773381568
CountryCode: US
TelephoneNumber: 8328151673
FaxNumber:  
Practice Location
Address1: 110 CYPRESS STATION DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770901630
CountryCode: US
TelephoneNumber: 8322531188
FaxNumber: 8322531181
Other Information
ProviderEnumerationDate: 08/13/2018
LastUpdateDate: 08/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X886895TXY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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