Healthcare Provider Details

I. General information

NPI: 1952062994
Provider Name (Legal Business Name): STACY KERRIAN WILLIAMS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4961 W ATLANTIC AVE STE 34
DELRAY BEACH FL
33445-3894
US

IV. Provider business mailing address

4961 W ATLANTIC AVE STE 34
DELRAY BEACH FL
33445-3894
US

V. Phone/Fax

Practice location:
  • Phone: 954-870-0261
  • Fax: 954-827-3249
Mailing address:
  • Phone: 954-870-0261
  • Fax: 954-827-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017139
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: