Healthcare Provider Details

I. General information

NPI: 1992006399
Provider Name (Legal Business Name): LEANN ELIZABETH WILLIAMS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W MORRISON ST SUITE 5
FAYETTE MO
65248-1075
US

IV. Provider business mailing address

600 W MORRISON ST
FAYETTE MO
65248-1471
US

V. Phone/Fax

Practice location:
  • Phone: 660-248-2900
  • Fax: 660-831-3372
Mailing address:
  • Phone: 660-248-2900
  • Fax: 660-831-3372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2010012057
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: