Healthcare Provider Details

I. General information

NPI: 1356696371
Provider Name (Legal Business Name): KIMBERLEE D WILLIAMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLEE D GILBERT

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 W 5TH ST, STE 112
SHERIDAN WY
82801-2752
US

IV. Provider business mailing address

1333 W 5TH ST, STE 110
SHERIDAN WY
82801-2752
US

V. Phone/Fax

Practice location:
  • Phone: 307-675-2650
  • Fax: 307-675-2651
Mailing address:
  • Phone: 307-675-2650
  • Fax: 307-675-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number23173.1177
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23173.1177
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: