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General NPI Number Information
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NPI Number | 1396942074
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Entity Type | Individual
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Provider Name | JACQUELYN COUNTS WILLIAMS APRN
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3521 DEL REY BLVD STE B
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City | LAS CRUCES
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State | NM
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Zip | 88012-7708
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Country | US
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Telephone | 575-522-7260
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Fax |
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Provider Business Mailing Address
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Address Line | 3521 DEL REY BLVD STE B
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City | LAS CRUCES
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State | NM
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Zip | 88012-7708
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Country | US
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Telephone | 575-522-7260
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Fax | 575-522-1355
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | R28880
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R28880
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License Number State | NM
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