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General NPI Number Information
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NPI Number | 1578947925
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Entity Type | Individual
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Provider Name | MARY WILLIAMS MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 1205 E 35TH ST
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City | TEXARKANA
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State | AR
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Zip | 71854-2746
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Country | US
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Telephone | 903-614-5355
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Fax | 903-614-5399
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Provider Business Mailing Address
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Address Line | 1299 MC 152
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City | DODDRIDGE
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State | AR
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Zip | 71834-1695
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Country | US
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Telephone | 903-277-9705
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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 | A004459
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License Number State | AR
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