Healthcare Provider Details

I. General information

NPI: 1164973665
Provider Name (Legal Business Name): BEVERLY LYNN WILLIAMS AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

996 FREEMAN RIDGE RD
NASHVILLE IN
47448-8485
US

IV. Provider business mailing address

996 FREEMAN RIDGE RD
NASHVILLE IN
47448-8485
US

V. Phone/Fax

Practice location:
  • Phone: 317-509-3610
  • Fax:
Mailing address:
  • Phone: 317-509-3610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number71006637A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: