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General NPI Number Information
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NPI Number | 1588270458
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Entity Type | Individual
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Provider Name | JACQUELINE WILLIAMS NP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 5457 TWIN KNOLLS RD STE 1048
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City | COLUMBIA
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State | MD
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Zip | 21045-3259
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Country | US
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Telephone | 104-247-2624
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Fax | 855-733-0059
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Provider Business Mailing Address
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Address Line | 5457 TWIN KNOLLS ROAD SUITE 300 #1048
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City | COLUMBIA
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State | MD
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Zip | 21045-3259
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Country | US
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Telephone | 410-424-7262
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Fax | 855-743-0059
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R210252
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License Number State | MD
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