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General NPI Number Information
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NPI Number | 1699161562
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Entity Type | Organization
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Legal Business Name | DENIESE WILLIAMS LLC
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 6526 S KANNER HWY UNIT 221
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City | STUART
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State | FL
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Zip | 34997-6396
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Country | US
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Telephone | 754-245-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 6526 S KANNER HWY UNIT 221
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City | STUART
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State | FL
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Zip | 34997-6396
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Country | US
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Telephone | 754-245-5480
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | DENIESE WILLIAMS
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Credential | ARNP
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Telephone | 754-245-5480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP 2886402
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License Number State | FL
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