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General NPI Number Information
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NPI Number | 1225282858
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Entity Type | Individual
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Provider Name | AUDRA ANN WILLIAMS FNP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 1301 N SAGINAW BLVD
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City | SAGINAW
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State | TX
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Zip | 76179-5095
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Country | US
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Telephone | 918-931-8453
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Fax |
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Provider Business Mailing Address
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Address Line | 5005 LINCOLN OAKS DR S APT 204
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City | FORT WORTH
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State | TX
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Zip | 76132-2206
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Country | US
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Telephone | 918-931-8453
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0080956
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 813218
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License Number State | TX
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