Healthcare Provider Details

I. General information

NPI: 1841060159
Provider Name (Legal Business Name): JULIE ANN WILLIAMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13209 HIGHWAY 96
MILLPORT AL
35576-2456
US

IV. Provider business mailing address

1456 FERNBANK RD
MILLPORT AL
35576-3368
US

V. Phone/Fax

Practice location:
  • Phone: 205-662-8801
  • Fax: 205-662-8802
Mailing address:
  • Phone: 662-574-0651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1-169055
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: