Healthcare Provider Details

I. General information

NPI: 1811437387
Provider Name (Legal Business Name): KARRIE R WILLIAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2017
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 LAKEVIEW DR
PADUCAH KY
42001-5619
US

IV. Provider business mailing address

1101 PROFESSIONAL BLVD STE 100
EVANSVILLE IN
47714-8018
US

V. Phone/Fax

Practice location:
  • Phone: 270-554-8373
  • Fax: 270-554-8987
Mailing address:
  • Phone: 812-477-7246
  • Fax: 812-477-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3011056
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3011056
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: