Healthcare Provider Details

I. General information

NPI: 1679991624
Provider Name (Legal Business Name): DENIESE WILLIAMS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DENIESE WOODBURN

II. Dates (important events)

Enumeration Date: 04/06/2014
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7333 SCOTLAND WAY OFC
SARASOTA FL
34238-8556
US

IV. Provider business mailing address

7333 SCOTLAND WAY OFC
SARASOTA FL
34238-8556
US

V. Phone/Fax

Practice location:
  • Phone: 941-552-5355
  • Fax: 941-552-5309
Mailing address:
  • Phone: 941-552-5355
  • Fax: 941-552-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 2886402
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN2886402
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP 2886402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: