Healthcare Provider Details

I. General information

NPI: 1356631022
Provider Name (Legal Business Name): HENRETTA N MILTON-WILLIAMS APRN, FPMHNP-BC, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 COLONIAL DR
COLUMBIA SC
29203-6818
US

IV. Provider business mailing address

2715 COLONIAL DR
COLUMBIA SC
29203-6818
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-7174
  • Fax: 803-898-2194
Mailing address:
  • Phone: 803-898-7174
  • Fax: 803-898-2194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number17710
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: