MEDICARE: KIRSTEN WILLIAMS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	4043082	KY

General Provider Information

NPI Number	:	1013884709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN WILLIAMS APRN

Provider Business Mailing Address
First Line	:	217 LA GRANGE RD
Second Line	:
City	:	PEWEE VALLEY
State	:	KY
Zip	:	40056-9174
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 LA GRANGE RD
Second Line	:
City	:	PEWEE VALLEY
State	:	KY
Zip	:	40056-9174
Country	:	US
Telephone Number	:	502-999-5165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/20/2025

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