Healthcare Provider Details

I. General information

NPI: 1174886576
Provider Name (Legal Business Name): EMILY M WILLIAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY M DORTON NP

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

2830 VICTORY PKWY LL-30
CINCINNATI OH
45206-1785
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-1631
  • Fax: 513-862-2694
Mailing address:
  • Phone: 513-245-3637
  • Fax: 513-475-7259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.346418
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA.13728NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: