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General NPI Number Information
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NPI Number | 1700426079
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Entity Type | Individual
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Provider Name | CHARISSA K WILLIAMS APNP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 2500 E CAPITOL DRIVE
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City | APPLETON
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State | WI
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Zip | 54911-8735
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Country | US
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Telephone | 920-364-3600
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Fax | 920-364-3900
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Provider Business Mailing Address
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Address Line | 122 E COLLEGE AVE
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City | APPLETON
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State | WI
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Zip | 54911-5741
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Country | US
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Telephone | 920-996-3264
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Fax | 920-830-5910
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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 | 197423
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9855
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License Number State | WI
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