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General NPI Number Information
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NPI Number | 1730468018
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Entity Type | Individual
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Provider Name | CAMILLE V WILLIAMS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 109 N BLUE JAY DR
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City | LIBERTY
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State | MO
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Zip | 64068-1906
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Country | US
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Telephone | 816-691-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 CLAY EDWARDS DR SUITE 240
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3251
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Country | US
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Telephone | 816-691-5287
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Fax | 816-346-7690
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2015002155
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License Number State | MO
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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 | 2015002155
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 823141
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 105935
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 2015002155
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License Number State | MO
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