Healthcare Provider Details

I. General information

NPI: 1477469880
Provider Name (Legal Business Name): ELIZABETH WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 W 74TH ST
SHAWNEE MISSION KS
66204-4004
US

IV. Provider business mailing address

9081 MAURER CT APT 8403
LENEXA KS
66219-1261
US

V. Phone/Fax

Practice location:
  • Phone: 913-676-2000
  • Fax:
Mailing address:
  • Phone: 913-529-9349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number152022
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: