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General NPI Number Information
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NPI Number | 1114779840
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Entity Type | Individual
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Provider Name | CHANELL S WILLIAMS DNP, FNP, ENP
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Gender | Female
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 150 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07103
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Country | US
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Telephone | 973-972-2676
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CLARA MAASS DR
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3550
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Country | US
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Telephone | 908-472-9609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 969889
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95295135
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 26NR19308300
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95034229
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F355672-01
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ15130900
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License Number State | NJ
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