Healthcare Provider Details

I. General information

NPI: 1023882859
Provider Name (Legal Business Name): MRS. CHLOE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26279 HIGHWAY 195
DOUBLE SPRINGS AL
35553-2554
US

IV. Provider business mailing address

26279 HIGHWAY 195
DOUBLE SPRINGS AL
35553-2554
US

V. Phone/Fax

Practice location:
  • Phone: 205-489-3322
  • Fax: 205-489-3325
Mailing address:
  • Phone: 205-489-3322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-173382
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: