Healthcare Provider Details

I. General information

NPI: 1104234905
Provider Name (Legal Business Name): SAPHINA WILLIAMS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4689 US HIGHWAY 17 STE 2-5
FLEMING ISLAND FL
32003-4831
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 904-269-6526
  • Fax: 904-269-6527
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9195879
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: