Healthcare Provider Details

I. General information

NPI: 1851568554
Provider Name (Legal Business Name): MONIQUE WILLIAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR
BETHESDA MD
20892-5913
US

IV. Provider business mailing address

PO BOX 60902
POTOMAC MD
20859-0902
US

V. Phone/Fax

Practice location:
  • Phone: 240-858-3151
  • Fax:
Mailing address:
  • Phone: 734-476-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704231709
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704231709
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR224931
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704231709
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR224931
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: