MEDICARE: FELECIA PRESTON-WILLIAMS CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R862911	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2006005827-22	OTHER	MS	ANCC
2	R862911	OTHER	MS	MS BOARD OF NURSING

General Provider Information

NPI Number	:	1538246632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELECIA PRESTON-WILLIAMS CFNP

Provider Business Mailing Address
First Line	:	P.O BOX 155
Second Line	:
City	:	HOLLANDALE
State	:	MS
Zip	:	38748-3723
Country	:	US
Telephone Number	:	662-822-1861
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 W WASHINGTON ST
Second Line	:
City	:	HOLLANDALE
State	:	MS
Zip	:	38748
Country	:	US
Telephone Number	:	662-807-5007
Fax Number	:	662-807-5019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/21/2024

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