Healthcare Provider Details
I. General information
NPI: 1336787100
Provider Name (Legal Business Name): KAWANA JEFFER WILLIAMS APRN, PH.D., NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/12/2019
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3030 30TH ST SE APT 301
WASHINGTON DC
20020-1657
US
IV. Provider business mailing address
1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US
V. Phone/Fax
- Phone: 240-620-1587
- Fax:
- Phone: 240-620-1587
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0700X |
| Taxonomy | Adult Development & Aging Psychologist |
| License Number | RN1039613 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | RN1039613 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | 0001264103 |
| License Number State | VA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | 0001264103 |
| License Number State | DC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | RN1039613 |
| License Number State | DC |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TS0200X |
| Taxonomy | School Psychologist |
| License Number | RN1039613 |
| License Number State | DC |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TS0200X |
| Taxonomy | School Psychologist |
| License Number | 0001264103 |
| License Number State | MD |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | 0001264103 |
| License Number State | MD |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | RN1039613 |
| License Number State | MD |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | 0001264103 |
| License Number State | VA |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | 0001264103 |
| License Number State | MD |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | RN1039613 |
| License Number State | DC |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1744R1102X |
| Taxonomy | Research Study Specialist |
| License Number | 0001264103 |
| License Number State | DC |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | RN1039613 |
| License Number State | DC |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1744R1102X |
| Taxonomy | Research Study Specialist |
| License Number | RN1039613 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
