Healthcare Provider Details

I. General information

NPI: 1649985474
Provider Name (Legal Business Name): JENNIFER WILLIAMS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 TOWSON AVE
FORT SMITH AR
72901-4921
US

IV. Provider business mailing address

5224 75TH ST STE D
LUBBOCK TX
79424-2525
US

V. Phone/Fax

Practice location:
  • Phone: 479-441-5078
  • Fax:
Mailing address:
  • Phone: 806-712-1096
  • Fax: 806-771-2093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number223098
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: