Healthcare Provider Details

I. General information

NPI: 1730520388
Provider Name (Legal Business Name): MITZI DIGNOS WILLIAMS APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MITZI URSAL DIGNOS ANP-C

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SKYLINE DR
JACKSON TN
38301-3923
US

IV. Provider business mailing address

PO BOX 400
JACKSON TN
38302-0400
US

V. Phone/Fax

Practice location:
  • Phone: 731-422-0213
  • Fax: 731-422-0409
Mailing address:
  • Phone: 731-425-5752
  • Fax: 731-422-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN0000017585
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN0000017585
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: