MEDICARE: EMILY L WILLIAMS NP

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	26NJ14901400	NJ
2	363L00000X	Nurse Practitioner	SP026509	PA

General Provider Information

NPI Number	:	1710695796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY L WILLIAMS NP

Provider Business Mailing Address
First Line	:	1815 JOHN F KENNEDY BLVD APT 822
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1707
Country	:	US
Telephone Number	:	856-404-0203
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 ISLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2028
Country	:	US
Telephone Number	:	267-597-3600
Fax Number	:

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

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	03/11/2024

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