Healthcare Provider Details
I. General information
NPI: 1356618987
Provider Name (Legal Business Name): ASHLEY KIRKPATRICK WILLIAMS PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1817 W MORRIS BLVD
MORRISTOWN TN
37813-2837
US
IV. Provider business mailing address
927 COILE RD
JEFFERSON CITY TN
37760-4011
US
V. Phone/Fax
- Phone: 423-581-3904
- Fax:
- Phone: 865-712-2737
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0200X |
| Taxonomy | Pediatric Clinical Nurse Specialist |
| License Number | 16168 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: