Healthcare Provider Details

I. General information

NPI: 1154261436
Provider Name (Legal Business Name): HARLEY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 AL-21
ATMORE AL
36502-6626
US

IV. Provider business mailing address

5850 AL-21
ATMORE AL
36502
US

V. Phone/Fax

Practice location:
  • Phone: 251-368-6245
  • Fax:
Mailing address:
  • Phone: 251-368-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF05260494
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-175597
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: