Healthcare Provider Details

I. General information

NPI: 1366424301
Provider Name (Legal Business Name): REBECCA L WILLIAMS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1948 AL HIGHWAY 157 SUITE 380
CULLMAN AL
35058-0642
US

IV. Provider business mailing address

503 CLARK ST NE
CULLMAN AL
35055-1921
US

V. Phone/Fax

Practice location:
  • Phone: 256-739-4131
  • Fax: 256-739-6027
Mailing address:
  • Phone: 256-739-1759
  • Fax: 256-739-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number1027358
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: