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General NPI Number Information
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NPI Number | 1821704974
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Entity Type | Individual
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Provider Name | DEMETRE DELINE WILLIAMS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 2330 N HIGHWAY 67
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City | FLORISSANT
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State | MO
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Zip | 63033-2034
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Country | US
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Telephone | 314-594-3618
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Fax |
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 888-987-1151
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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 | 2023006453
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License Number State | MO
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