Healthcare Provider Details

I. General information

NPI: 1437305828
Provider Name (Legal Business Name): JUDITH K WILLIAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDITH KIZZA

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 CAMBRIDGE ST
CAMBRIDGE MA
02139-1099
US

IV. Provider business mailing address

1493 CAMBRIDGE ST
CAMBRIDGE MA
02139-1099
US

V. Phone/Fax

Practice location:
  • Phone: 617-999-0973
  • Fax:
Mailing address:
  • Phone: 617-665-1068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN275861
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number275861
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: