Healthcare Provider Details

I. General information

NPI: 1265670160
Provider Name (Legal Business Name): ANGELA MICHELLE WILLIAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 CANTERWOOD DR
WILMINGTON NC
28401-7300
US

IV. Provider business mailing address

2311 CANTERWOOD DR
WILMINGTON NC
28401-7300
US

V. Phone/Fax

Practice location:
  • Phone: 910-996-3461
  • Fax:
Mailing address:
  • Phone: 910-996-3461
  • Fax: 910-390-6285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5016654
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number210533
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number210533
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: