Healthcare Provider Details

I. General information

NPI: 1174064828
Provider Name (Legal Business Name): PRISCILLA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 TEDDY LN STE 2000E
LONE TREE CO
80124-6740
US

IV. Provider business mailing address

9220 TEDDY LN STE 2000E
LONE TREE CO
80124-6740
US

V. Phone/Fax

Practice location:
  • Phone: 303-351-1410
  • Fax: 303-590-3230
Mailing address:
  • Phone: 303-351-1410
  • Fax: 303-590-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2000012558
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: