Healthcare Provider Details

I. General information

NPI: 1538714332
Provider Name (Legal Business Name): TRACEE ROBERSON WILLIAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 MOWRY RD UF INSTITUE ON AGING; DEPARTMENT OF AGING AND GERIATRIC
GAINESVILLE FL
32603
US

IV. Provider business mailing address

1609 NW 29TH RD APT 138
GAINESVILLE FL
32605-3038
US

V. Phone/Fax

Practice location:
  • Phone: 352-294-5800
  • Fax:
Mailing address:
  • Phone: 863-605-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11003447
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11003447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: