=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841060159
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE ANN WILLIAMS FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2024
-----------------------------------------------------
Last Update Date | 01/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13209 HIGHWAY 96
-----------------------------------------------------
City | MILLPORT
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35576-2456
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-662-8801
-----------------------------------------------------
Fax | 205-662-8802
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1456 FERNBANK RD
-----------------------------------------------------
City | MILLPORT
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35576-3368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-574-0651
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 1-169055
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------