Healthcare Provider Details
I. General information
NPI: 1174119937
Provider Name (Legal Business Name): SARAH WILLIAMS, APRN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22461 INTERSTATE 30 STE 402
BRYANT AR
72022-2383
US
IV. Provider business mailing address
3858 FREEDOM CV
BENTON AR
72015-9750
US
V. Phone/Fax
- Phone: 501-481-8800
- Fax:
- Phone: 501-481-8800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
WILLIAMS
Title or Position: OWNER
Credential: DNP, APRN
Phone: 501-481-8800