Healthcare Provider Details

I. General information

NPI: 1982748265
Provider Name (Legal Business Name): CYNTHIA RENEE' WILLIAMS NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA RENEE' CHADWELL NURSE PRACTITIONER

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 01/06/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 CENTRAL PIKE STE 500
HERMITAGE TN
37076-3431
US

IV. Provider business mailing address

9200 SHELBYVILLE RD STE 531
LOUISVILLE KY
40222-5132
US

V. Phone/Fax

Practice location:
  • Phone: 502-792-0236
  • Fax:
Mailing address:
  • Phone: 502-792-0236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number91404
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11952
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: