Healthcare Provider Details

I. General information

NPI: 1629019757
Provider Name (Legal Business Name): JANICE KETCHAM WILLIAMS FNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 KNOLL NORTH DR STE 370
COLUMBIA MD
21045-2393
US

IV. Provider business mailing address

11910 FROST DR
BOWIE MD
20720-4429
US

V. Phone/Fax

Practice location:
  • Phone: 410-837-2050
  • Fax:
Mailing address:
  • Phone: 301-352-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR135421
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: