Healthcare Provider Details

I. General information

NPI: 1346173390
Provider Name (Legal Business Name): REBEKAH DIANE WILLIAMS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1130 S MAIN ST
ENGLEWOOD OH
45322-2819
US

IV. Provider business mailing address

1478 ARTESIAN LN
FAIRBORN OH
45324-3872
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-6879
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042369
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: