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General NPI Number Information
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NPI Number | 1740909225
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Entity Type | Individual
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Provider Name | KATHLEEN JUDITH WILLIAMS CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 648 N MAIN ST
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City | TAYLOR
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State | PA
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Zip | 18517-1112
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Country | US
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Telephone | 570-348-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 908 SNYDER AVE
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City | SCRANTON
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State | PA
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Zip | 18504-3153
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Country | US
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Telephone | 570-309-7195
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP026134
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License Number State | PA
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