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General NPI Number Information
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NPI Number | 1174157556
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Entity Type | Individual
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Provider Name | TETYANA WILLIAMS MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 6980 S M 52
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City | OWOSSO
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State | MI
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Zip | 48867-9515
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Country | US
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Telephone | 989-729-7779
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Fax | 989-729-7313
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Provider Business Mailing Address
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Address Line | PO BOX 519
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City | LAINGSBURG
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State | MI
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Zip | 48848-0519
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Country | US
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Telephone | 989-729-7779
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Fax | 989-729-7313
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704290197
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License Number State | MI
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