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General NPI Number Information
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NPI Number | 1386511053
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Entity Type | Individual
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Provider Name | BRANDON L MCWILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 10/18/2025
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 1 AUDUBON PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40217-1318
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Country | US
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Telephone | 502-718-4385
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Fax |
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Provider Business Mailing Address
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Address Line | 1715 TENNYSON DR
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2039
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Country | US
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Telephone | 502-718-4385
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4013921
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License Number State | KY
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