Healthcare Provider Details

I. General information

NPI: 1679826853
Provider Name (Legal Business Name): CHERYL DENISE WILLIAMS ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYL DENISE POPEJOY

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 N COLLINS BLVD STE 607
RICHARDSON TX
75080-2636
US

IV. Provider business mailing address

PO BOX 9261
WICHITA FALLS TX
76308-9261
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-3451
  • Fax:
Mailing address:
  • Phone: 940-764-7236
  • Fax: 940-764-7237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP121933
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number554597
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: