Healthcare Provider Details

I. General information

NPI: 1396162459
Provider Name (Legal Business Name): BRITTNEY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 AUBURN AVE NE
ATLANTA GA
30312-1504
US

IV. Provider business mailing address

460 AUBURN AVE NE
ATLANTA GA
30312-1504
US

V. Phone/Fax

Practice location:
  • Phone: 404-523-1613
  • Fax: 404-681-4536
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number273041737
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: