Healthcare Provider Details

I. General information

NPI: 1093308934
Provider Name (Legal Business Name): CAROLINE F WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOWELL MILL RD NW STE 450
ATLANTA GA
30318-2508
US

IV. Provider business mailing address

1800 HOWELL MILL RD NW STE 450
ATLANTA GA
30318-2508
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-4393
  • Fax: 404-609-7665
Mailing address:
  • Phone: 404-355-4393
  • Fax: 404-609-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberLD005794
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: