Healthcare Provider Details

I. General information

NPI: 1497113948
Provider Name (Legal Business Name): JENNIFER FAYE WILLIAMS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER FAYE FLOWERS FNP-C

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 E TYLER ST
ATHENS TX
75751-2145
US

IV. Provider business mailing address

820 COUNTY ROAD 3824
ATHENS TX
75752-4094
US

V. Phone/Fax

Practice location:
  • Phone: 903-292-5015
  • Fax:
Mailing address:
  • Phone: 903-203-1254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number669224
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP130132
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: