Healthcare Provider Details

I. General information

NPI: 1730557752
Provider Name (Legal Business Name): CIERRA WILLIAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 HIGHWAY 34 E
NEWNAN GA
30265-1323
US

IV. Provider business mailing address

1425 HIGHWAY 34 E
NEWNAN GA
30265-1323
US

V. Phone/Fax

Practice location:
  • Phone: 770-304-3724
  • Fax: 770-304-3726
Mailing address:
  • Phone: 770-304-3724
  • Fax: 770-304-3726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberRN233631
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN233631
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: