Healthcare Provider Details

I. General information

NPI: 1538986484
Provider Name (Legal Business Name): TAYLOR DAWN WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 E DIMOND BLVD STE 1
ANCHORAGE AK
99515-2031
US

IV. Provider business mailing address

349 E 24TH AVE APT 4
ANCHORAGE AK
99503-2121
US

V. Phone/Fax

Practice location:
  • Phone: 907-344-2400
  • Fax:
Mailing address:
  • Phone: 304-588-2167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number227733
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: