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General NPI Number Information
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NPI Number | 1336719988
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Entity Type | Individual
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Provider Name | MONIQUE L WILLIAMS APRN
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Gender | Female
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Dates
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Enumeration Date | 06/27/2021
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 1536 N JEFFERSON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6525
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Country | US
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Telephone | 904-475-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 5140 GATE PKWY APT 2204
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0234
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Country | US
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Telephone | 904-613-4470
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11013759
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License Number State | FL
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