Healthcare Provider Details

I. General information

NPI: 1689113581
Provider Name (Legal Business Name): CHIKIRA WILLIAMS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 FORTRESS BLVD
MORGANTOWN WV
26508-1351
US

IV. Provider business mailing address

423 FORTRESS BLVD
MORGANTOWN WV
26508-1351
US

V. Phone/Fax

Practice location:
  • Phone: 844-852-9510
  • Fax:
Mailing address:
  • Phone: 844-852-9510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.015596
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: