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General NPI Number Information
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NPI Number | 1679913115
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Entity Type | Individual
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Provider Name | TIFFANY TEAL WILLIAMS APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 3704 NORTH BLVD SUITE C
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3658
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Country | US
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Telephone | 318-443-4576
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Fax | 318-449-5579
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Provider Business Mailing Address
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Address Line | 3704 NORTH BLVD SUITE C
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3658
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Country | US
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Telephone | 318-443-4576
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Fax | 318-449-5579
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN119235
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP07330
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License Number State | LA
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