Healthcare Provider Details

I. General information

NPI: 1467082511
Provider Name (Legal Business Name): JESSICA LYNN WILLIAMS WHNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N EDWARDS ST
ENTERPRISE AL
36330-2584
US

IV. Provider business mailing address

205 CENTRE DR
DOTHAN AL
36303-9338
US

V. Phone/Fax

Practice location:
  • Phone: 334-347-0584
  • Fax:
Mailing address:
  • Phone: 615-917-2325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1-144303
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1-144303
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: