Healthcare Provider Details

I. General information

NPI: 1417833989
Provider Name (Legal Business Name): MONIQUE RENNE WILLIAMS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8545 AZ 95
MOHAVE VALLEY AZ
86440
US

IV. Provider business mailing address

8545 AZ 95
MOHAVE VALLEY AZ
86440
US

V. Phone/Fax

Practice location:
  • Phone: 928-201-3422
  • Fax:
Mailing address:
  • Phone: 928-201-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number327865
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: