Healthcare Provider Details
I. General information
NPI: 1023537248
Provider Name (Legal Business Name): ANGELA DAWN WILLIAMS FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/19/2017
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5321 BEVERLY PARK CIR
KNOXVILLE TN
37918-9253
US
IV. Provider business mailing address
7951 E MAPLEWOOD AVE STE 118
GREENWOOD VILLAGE CO
80111-4724
US
V. Phone/Fax
- Phone: 865-687-1321
- Fax:
- Phone: 720-638-0846
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 22993 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 22993 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: